Insurance and Billing Specialist – Full-time

Concord Counseling Services•Westerville, OH

About The Position

The Insurance & Billing Specialist position serves as a key role in improving the overall effectiveness of revenue cycle collections. The applicant will need to have an extensive background in the submission of claims to third party payers & an understanding of making corrections to maximize cash flow in a healthcare environment, preferably within community mental health. The applicant should also have a background working with electronic medical records (EMR) system software that is utilized to maximize correct third party claim submission. Applicant will become a go-to resource for troubleshooting system issues that end users may have.

Requirements

Minimum 5 years of experience working with third party payers (preferably community mental health environment or healthcare setting)
Minimum 3 years of experience with Excel
Experience in claim follow-up in a healthcare practice environment preferred.
Assist with EMR infrastructure as it pertain to claim submission & payment data entry
Knowledge of Medicare and Medicaid regulations and other insurance guidelines
Understanding credentialing of direct service staff with third party payers
An understanding of healthcare billing to minimize the error rate in claim submission

Responsibilities

Responsible for proper and efficient setup of payer definitions within the EMR
Responsible for proper setup of client insurance upon intake
Credentialing of new staff with payers
Responsible for review & process of claims in various stages of revenue cycle in a timely manner.
Act as a liaison for clients with questions or issues
Responsible for itemized patient statements
Monitor work flow and recommend process/procedural improvements as needed.
Maintain compliance with federal, state and local regulations, HIPAA and the Corporate Responsibility Program