Why You’ll Love This Job
Are you interested in joining a dynamic company that delivers successful in home treatment to clients with substance use disorder? If you are a caring, compassionate and capable Billing and Reimbursement Specialist who meets or exceeds the following, we want to hear from you!
Position Summary:
The role of the Billing & Reimbursement Specialist is to analyze the claim submissions and billing process to determine appropriateness and accuracy. The Billing & Reimbursement Specialist is responsible for handling claims processing including Accounts Receivable aging/collections and reviewing returned, disputed or rejected claims from commercial payers.
Position Highlights
- This role is hybrid out of our Connecticut Office located in Wallingford, CT.
- Expectation is a minimum of 2 days in the office. *The initial 30 days may require additional in office time for training*
- This role is full-time non-exempt with a starting rate of $18-$21/hour
Benefits Highlights
Coverage: Health, vision and dental through Anthem Blue Cross Blue Shield, FSA, HSA that comes with an employer match, along with STD, LTD, life insurance, EAP, and more.
Balance: Competitive Paid Time Off (PTO) plan , 10 paid Holidays, 2 paid floating Holidays of your choice, and 7 Days of Sick Time
Development: Certification/continuing education eligibility, leadership development and 1 paid day off a year to go towards personal professional development.
Retirement: 401(k) retirement plan
Culture: Dedication to diversity, equity and inclusion, and a growing working environment.
Aware Recovery Care is an Equal Opportunity Employer
Job Duties and Responsibilities
Reasonable Accommodations Statement
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform the essential function
RESPONSILITIES:
- Ability to assess and track why payments are being billed incorrectly and appropriately create mitigation strategies to reduce additional risks.
- Work with external and internal staff to ensure on getting all claims paid in a timely manner.
- Obtain reimbursement from responsible parties by direct contact as needed to facilitate reimbursement.
- Manage a large number of accounts and claims.
- Ability to work 300 minutes on the phone/portal for claims adjudication.
- Manage claims via multiple platforms and systems.
- Ability to negotiate claims and resolve claims with external agencies.
- Ability to identify Verification of Benefits (VOB) issues as it pertains to claim resolution and resolve the issue or report the issue.
- Ability to assist with cash posting, posting charges, and/or assist with daily, weekly and monthly closing, as needed.
- Run claims, and cash posting reports daily, weekly, monthly and quarterly as assigned.
- Identify and communicate with payer and/or system trends to Management regarding unpaid claims, denials, reimbursement issues, etc.
- Maintain thorough knowledge of payer contract, regulations and guidelines, as well as State and Federal laws relating to reimbursement procedures to ensure accurate and compliant billing processes.
- Take initiative and action to respond and resolve customer billing and reimbursement inquiries in a timely manner.
- Initiate payer disputes, initiate appeals and exhaust all internal collection efforts.
- Make recommendations for collection trends.
- Outbound phone calls to payers.
- Outbound phone calls to clients.
- Collect on accounts and troubleshoot all inquiries from the organization and other entities based on insurance carrier information rules and regulations.
- Accountable for outstanding customer service that drives quality and an exceptional customer experience.
- Adapts to organizational change and departmental restructuring to fit the needs of our clients and payer sources.
- Perform miscellaneous job-related duties as assigned.
Qualifications
POSITION QUALIFICATIONS:
- High School graduate or equivalent
- Minimum two years of previous healthcare billing and reimbursement
- Knowledge of CMS 1500, CPT codes and ICD-10
- Knowledge of 837 billing processes and 835 processes
- Proficient keyboarding and computer skills including word processing, spreadsheet, and Client Accounts software
Key Competencies:
- Exceptional organizational and leadership skills
- Efficient work ethic
- Ability to easily adapt and multitask
- Strong ability to collaborate and perform in a team-oriented environment as demonstrated by prior experience
- Professional and proficient written and verbal communication
- High level of integrity and professionalism
- Goal and results oriented
- Resilient and able to perform under pressure
- Critical thinker
- Reliable
- Strives for excellent standards of quality
- Entrepreneurial spirit
- Commitment to ongoing learning and growth
- Ability to use electronic health records, phone systems, customer resource management software, and more general office computer systems
- Appreciation and respect for principles of diversity, equity, and inclusion. Ability to engage with diverse audiences (age, gender, nationality, race/ethnicity, profession, etc.)
Type: Full Time (Hourly)
Job ID: 123908