Insurance and Billing Specialist

Concord Counseling Services • Westerville, OH

2d

About The Position

The Insurance and Billing Specialist supports the effectiveness of revenue cycle collections by submitting claims to third-party payers, correcting claims to maximize cash flow, and helping ensure accurate claim submission in a healthcare environment. The role uses electronic medical record (EMR) software and serves as a resource for troubleshooting system issues reported by end users. Community mental health experience is preferred.

The specialist sets up payer definitions in the EMR and client insurance during intake, credentials new staff with payers, reviews and processes claims at various revenue-cycle stages, responds to client questions or issues, and prepares itemized patient statements. The role also monitors workflow, recommends process or procedural improvements, and maintains compliance with applicable regulations, HIPAA, and the Corporate Responsibility Program.

Requirements

• At least 5 years of experience working with third-party payers; community mental health or healthcare experience is preferred.
• At least 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 submitting claims to third-party payers and correcting claims to maximize cash flow.
• Background working with EMR system software used for third-party claim submission.

Nice To Haves

• Experience with third-party payers in a community mental health environment or healthcare setting.
• Experience in claim follow-up in a healthcare practice environment.

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 the Corporate Responsibility Program.
• 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