Job Description:
• Create and submit insurance claims for reimbursement in an accurate and timely manner.
• Process client payments, including credit card charges, payment arrangements, and follow-up on outstanding balances.
• Research and resolve claim issues, denials, and discrepancies to ensure proper reimbursement.
• Maintain effective communication with third-party insurance carriers to resolve issues that impede cash flow.
• Monitor and report on key metrics such as aged receivables, collections, days outstanding, non-billed claims, and denials.
• Download insurance payments and remittance information from payer portals and forward to the accounting team for posting.
• Understand and comply with HIPAA rules and regulations.
• Maintain a friendly, efficient, and positive customer service attitude toward clients and co-workers.
• Ability to work effectively both individually and as part of a team.
• Multitask and prioritize tasks efficiently.
• Understand revenue cycle management and insurance/benefit processes for mental health billing.
• Knowledge of claims reimbursement and collection efforts for commercial insurance plans.
• Must possess knowledge of Explanation of Benefits (EOBs), copays, coinsurance, deductibles, and denial codes.
• Read and interpret insurance provider manuals, EOBs, and remark codes.
• Excellent verbal and written communication, critical thinking, decision-making, and organizational skills.
• Provide proficient customer service and resolve inquiries accurately.
Qualifications:
• Understanding of revenue cycle management and experience regarding mental health billing and insurance/benefit information.
• Knowledge in claims reimbursement and collection efforts for commercial insurance plans.
• Knowledge in Explanation of Benefits (EOBs) and understanding of copays, coinsurance, deductibles, and denial codes.
• Attention to detail and ability to prioritize independently.
• Multitasking and time-management skills, with the ability to prioritize tasks.
• Shows ability to read and interpret insurance provider manuals.
• Shows ability to work effectively both individually and as a team.
• Shows ability to read Explanation of Benefits (EOBs) and remark codes and understand how they apply to the patient’s account.
• Demonstrates excellent interpersonal problem-solving and judgment skills with a high level of attention to detail and accuracy.
• Clear and coherent both written and verbal communication skills in English.
Screening Criteria:
• High school diploma or equivalent combination of education and work experience.
• Minimum of two (2) years of experience as a medical biller/collector.
• Experience in AR follow-up, denial management, and revenue cycle management.
• Experience in using computers and software applications.
• Must have stable employment history.
