Insurance and Billing Specialist

Concord Counseling Services • Westerville, OH

1d

About The Position

The Insurance & Billing Specialist supports the effectiveness of revenue cycle collections by managing third-party claims and helping ensure accurate claim submission and payment data entry. The position requires a substantial background working with third-party payers and electronic medical records (EMR), preferably in community mental health or another healthcare setting. The specialist also serves as a resource for troubleshooting system issues encountered by end users.

The role includes configuring payer and client insurance information in the EMR, credentialing new staff with payers, reviewing and processing claims throughout the revenue cycle, assisting clients with questions or issues, preparing itemized patient statements, monitoring workflows, and recommending process improvements. The specialist must maintain compliance with applicable federal, state, and local regulations, HIPAA, and the Corporate Responsibility Program Requirements.

Requirements

• Minimum 5 years of experience working with third-party payers, preferably in community mental health or a healthcare setting.
• Minimum 3 years of experience with Excel.
• Knowledge of Medicare and Medicaid regulations and other insurance guidelines.
• Understanding of credentialing direct service staff with third-party payers.
• Understanding of healthcare billing to minimize errors in claim submission.
• Background working with EMR system software used to support accurate third-party claim submission.

Nice To Haves

• Experience with claim follow-up in a healthcare practice environment.
• Experience working in community mental health.

Responsibilities

• Set up payer definitions properly and efficiently within the EMR.
• Set up client insurance upon intake.
• Credential new staff with payers.
• Review and process claims at various stages of the revenue cycle in a timely manner.
• Act as a liaison for clients with questions or issues.
• Prepare itemized patient statements.
• Monitor workflow and recommend process or procedural improvements as needed.
• Maintain compliance with federal, state, and local regulations, HIPAA, and Corporate Responsibility Program Requirements.
• Assist with EMR infrastructure related to claim submission and payment data entry.
• Troubleshoot system issues that end users may encounter.

Benefits

• Competitive pay.
• Supportive and flexible work environment with high employee satisfaction rates.
• Generous paid time off and holidays.
• Medical, dental, and vision coverage.
• Group life insurance.
• Flexible spending account (FSA).
• Health savings account (HSA).
• 401(k) plan.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed