Billing and Insurance Specialist

3 weeks ago

Kingston, Pennsylvania, United States Moriah Behavioral Health Full time

Job Type: Full-time

Description

SUMMARY: The Billing and Collections Specialist at Moriah Behavioral Health is responsible for billing services, collecting payments, maintaining records, and verifying insurance benefits. This role requires strong communication skills and adherence to policies and regulations such as CARF, HIPAA, client confidentiality, and Moriah Behavioral Health best practices.

Duties and Responsibilities

  • Maintains client demographic information and data collection systems.
  • Verifies insurance benefits and eligibility for behavioral health by utilizing online websites or by contacting carriers directly.
  • Communicates with Utilization Review/Admissions Teams for Verification of Benefits (VOB), change of insurance, etc.
  • Represents the Billing and Collections Department to all internal and external inquiries.
  • Responds to medical record requests from the insurances and follows up with Clinical Documentation Specialist.
  • Participates in educational activities and attends regular meetings.
  • Reviews client charts for attendance and updated information to ensure accuracy of billing.
  • Works seamlessly with Utilization Review, Clinical, and Admission Teams to develop best practices, policies, and procedures as they relate to Billing and Collections.
  • Maintains accurate financial records and follows payment procedures.
  • Monitors outstanding balances to ensure each account is paid on time and in full.
  • Monitors multiple client accounts.
  • Ensures all claims are error-free before submission.
  • Manages the status of accounts and balances and identifies inconsistencies.
  • Updates accounts receivable database and new accounts.
  • Ensures all clients remain informed on their outstanding debts and deadlines.
  • Provides solutions to any relative challenges of clients.
  • Notifies Clinical Documentation Specialist and/or Director of Billing and Collections if clinical data is not up to date.
  • Works closely with Team Members to create and submit claims as well as client statements.
  • Works closely with clients to create applicable payment plans for balances due.
  • Maintains current knowledge and understanding of the laws, regulations, and policies that pertain to Moriah Behavioral Health and insurance provider business practices.
  • Checks emails periodically throughout the day and responds appropriately.
  • Must be willing to work on-call rotation as assigned for nights and weekends as needed.
  • This position is required to be present in the office and is not a remote position.
  • Must be willing to work weekends as needed. When it is needed, unless otherwise required, you may work remotely via phone and email, etc.
  • Must be able to work flexible hours from 7 a.m. to 9 p.m. EST/EDT.
  • Able to build connections while creating trust and rapport.
  • Strong understanding of medical necessity criteria is preferred.
  • Maintains confidentiality and HIPAA compliance in accordance with Moriah Behavioral Health policies.
  • Maintains and meets CARF certification requirements in accordance with Moriah Behavioral Health policies.
  • Adherence to laws and best practices in regard to dealing with clients and confidential data.
  • Follows all Moriah Behavioral Health's policies and procedures.
  • Performs other related duties as assigned by Supervisor or Greater.

Requirements

QUALIFICATIONS:
  • High school diploma or general education degree (GED), 6 months of related experience and/or training, or equivalent combination of education and experience.
  • Possess the ability to function effectively in a team environment and interact productively with all levels of team personnel and outside contractors.
  • Basic Math and Accounting principles.
  • Can understand and follow oral and written instructions.
  • Ability to read, write the following: Work Orders, instructions, daily reports, and system manuals.
  • Ability to receive and relate orders/information using various communication devices.
  • Applicants must be either a U.S. Citizen or have the legal right to work in the United States.
  • Must meet federal, state, and local criminal clearance and child abuse indexing requirements.
  • Applicants must pass a drug screen and submit to random drug testing as requested.
  • Applicants are also required to pass a general medical examination.
  • Computer Skills Required. Preferred (but not required) knowledge of Kipu, Google Docs, Excel, Salesforce, Collaborative MD.
  • Must possess a valid Driver's License or State ID.

Salary Description

$30,000.00 annual Moriah Behavioral Health

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