The company's application is a financial, clinical, and resource management application directed at the Behavioral Healthcare Provider industry. This role will be responsible for various duties related to authorizations, billing claims, posting payments, and collecting accounts receivable. Our team's goal is to reduce the organization's accounts receivable through the OnTarget accounting system and provide excellent customer service to our clients and internal staff. Duties and Responsibilities:
- Create batch billing from time records and create all invoices for the clients as needed.
- Submit and ensure all client's electronic billing is processed according to payer timely filing guidelines as needed.
- Review and confirm all EDI reports are accepted by the payers with no rejections when needed.
- Triage and work all EDI rejections as needed.
- Confirm all provider numbers, NPI numbers and general billing information is configured in the client's database.
- Submit documentation to state offices (DSS) for deductible clients as needed.
- Process and submit paper billing for private pay and deductible clients.
- Collect all money due from payers, families, and government entities per the mandatory process.
- Resolve all claim denials per the mandatory process.
- Contact payer by phone, email, fax, or support ticket to resolve denials for client.
- Review accounts receivable to identify posting or billing issues and resolve these issues.
- Post electronic and manual payments to accounts within mandatory process.
- Provide A+ customer service to the Client and Finance Department of client.
- Retrieve and enter authorizations in EHR, following guidelines in mandatory process (alternate).
- Alternate contact for authorization department requests from clinical team.
- Triage and resolve issues, edit, and maintain authorizations (alternate).
- Maintain all service codes, billing configurations and rates per SOP (alternate).
- Run appropriate reports per the mandatory process to track on hold billing due to unapproved or dummy auths (alternate).
- Liaison between clients, payers, and authorization department (alternate).
- Execute all other job duties per the mandatory process.
Qualifications:
- Associate's or bachelor's degree in a healthcare related field preferred, but extensive hands-on experience will be considered
- Minimum of one (1) year experience in claims handling, healthcare billing, accounts receivable, aging reports, and/or posting payments required
- Experience with 837 and 835 file processing is a plus
- Experience working with North Carolina Managed Care Organizations (MCOs) is a plus
- Must have excellent customer service skills
- Ability to work independently
- Strong attention to detail and high level of accuracy
- Ability to prioritize workload and maintain an organized system for processes
- Excellent written and verbal communication skills
- Proficiency in Microsoft Office products, including Outlook, Excel, and SharePoint