Reimbursement Specialist
3 weeks ago
Mid-Columbia Center for Living is seeking a highly skilled Reimbursement Specialist to join our team. As a Reimbursement Specialist, you will be responsible for processing and documenting MCCFL services to ensure timely collection of receivables from Medicaid, Medicare, and other reimbursement sources.
Key Responsibilities- Compile and review billing data to ensure accuracy of all billing information, including CPT codes, OHP codes, cost center codes, bundling of services, and total fees.
- Analyze, understand, and interpret billing software upgrades and coding change effects on customers' accounts receivables.
- Perform monthly processing of outstanding third-party billing.
- Monitor aged accounts receivable for assigned payer groups monthly.
- Take appropriate action to resolve open balances for non-OHP clients.
- Inform clinicians of client balances over 60 days for counseling on collection.
- Prompt follow-up and correction of billing errors, rejections, insurance company errors, and inquiries.
- Send monthly statements to clients and separate out special handling statements for alternative processing.
- Perform data entry tasks in MCCFL's billing system, including third-party payments, electronic health records data, and fee adjustments as noted on reconsideration forms.
- Review data entry work to ensure accuracy.
- Inform screeners and providers of client insurance eligibility within 24 business hours of notification for new and re-opened clients.
- Verify coverage for OHP clients on community partner invoices, notifying managers and supervisors of client's eligibility.
- Maintain batched billing data and upload to the clearinghouse on a scheduled basis.
- Check daily activity in the billing system, input corrections, and advise Business Services of changes.
- Prepare and submit encounter measurement data for Mental Health (MH) and Alcohol & Drug (SUD) services to MCCFL's affiliated Coordinated Care Organizations (CCO) in the format requested, either electronically or on paper.
- Confirm OHP eligibility through the Medicaid Management Information System (MMIS).
- Assist and support clients in the OHP enrollment process.
- Respond to client/staff inquiries regarding billing status, providing resolution information in a professional manner.
- Travel between MCCFL locations and attend required meetings and/or trainings.
- Regular and reliable attendance; professional communication; maintain confidentiality.
- Competitive salary, dependent on experience.
- 95% employer-paid comprehensive medical, dental, and vision coverage for employees only. Low deductible plans for family coverage through PEBB.
- PERS Retirement Contribution.
- 11 Holidays, including 1 floating holiday.
- 10 vacation days a year for exempt employees.
- 12 sick days a year.
- Education reimbursement and loan forgiveness- HRSA.
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