Administrative Program Specialist-B

State of Louisiana • Monroe, LA

1d • Onsite

About The Position

NORTHEAST DELTA HUMAN SERVICES AUTHORITY MISSION: Serve as a catalyst for individuals with mental health, developmental disabilities, and addictive disorders to help them realize their full human potential by offering quality, excellent care with greater accessibility. Northeast Delta Human Services Authority is seeking an Administrative Program Specialist-B to provide administrative support with all aspects of outside billing source provider who serves seven Behavioral Health and Primary Care Outpatient Clinics. This position is a journeyman level, which provides clerical support with minimal instructions and directions. An ideal candidate should possess the following competencies: Demonstrating Accountability: The ability to take ownership of actions, behaviors, performance, decisions, and outcomes. Making Accurate Judgments: The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning. Managing Resources: The ability to manage financial, physical, and contractual resources to ensure compliance and maximize business value.

Requirements

• Four years of experience in administrative services; OR Six years of full-time work experience in any field plus one year of experience in administrative services; OR A bachelor's degree plus one year of experience in administrative services; OR An advanced degree.
• Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.

Responsibilities

• Serves as the primary liaison for the following: a Billing Service provider; the EHR (CT1) that includes troubleshooting to resolve issues and submitting charging codes and updates rate to CT1 as needed; and between service providers and insurance companies while facilitating the credentialing and re-credentialing process with contracted insurance companies, NEDHSA Integrated Care Clinics, and service providers to ensure staff is eligible to provide care to patients and bill services at these clinics.
• Acts as agency administrator for Vantage provider portal and any other insurance provider agency contact as needed.
• Responsible for reviewing Claim Rejections and Denials with billing provider to ensure they are tracking and reconciling claims submission report in the clearinghouse system with Action Code Summary report to EHR (electronic health records) system for seven clinics for claims entered versus claims submitted.
• Serves as point of contact for establishing and maintaining insurance contracts for the agency for the purpose of becoming network participants and maintain network participation with insurances.
• Enroll the agency in ERA/EFT participation with insurance companies.
• This role also gathers information from service providers and other sources in order to initiate the credentialing application process using verification websites to confirm the accuracy of data provided by service providers.
• Maintain well organized files for correspondence and claims reports.

Benefits

• NEDHSA is a designated approved National Health Service Corps (NHSC) site. Clinicians who work at NHSC-approved sites are eligible to apply to the NHSC Loan Repayment Program to pay off student loans.
• 2-year Full-Time Clinical Practice: NHSC will pay up to $50,000 for an initial 2 years of full-time clinical practice to clinicians. (Full-time clinical practice is defined as no less than 40 hours per week, for a minimum of 45 weeks per year.)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level