Senior Billing and Collections Specialist

ROWI Teen & Parent Wellness Centers•Thousand Oaks, CA

112d•$30 - $32•Onsite

About The Position

The Senior Billing and Collections Specialist is responsible for monitoring claim status, researching rejections and denials, documenting related account activities within CollaborateMD, posting adjustments, and assisting with collections from commercial insurance payers. The Senior Billing and Collections Specialist must possess critical thinking and problem-solving skills with an understanding of commercial insurance payer payment methods to correctly record contractual adjustments based on payer contracts. In addition, the Senior Billing and Collections Specialist must demonstrate proficiency within the billing system to ensure all functionality is utilized for efficient processing of claims in a timely manner.

Requirements

Working knowledge of CollaborateMD and KIPU required
Private insurance experience required (Behavioral Health preferred)
Must have critical thinking skills
Proficient in Excel
Working knowledge of CPT/revenue codes preferred
Working knowledge of commercial insurance carrier billing requirements
Ability to read and understand EOB’s
Ability to work with In-Network and Out-of-Network carriers
Ability to manage time effectively.
Ability to work with minimal supervision.
Proficient in basic computer skills.
Able to maintain clear boundaries with clients and staff.
Work effectively within an interdisciplinary team environment
Minimum of a high school diploma required.
Knowledge of business and accounting processes within mental health billing capacity.
3-5 years of mental health billing experience required
Strong interpersonal and organizational skills.
Excellent written and verbal communication skills.
Ability to set priorities and handle multiple assignments.
Must exercise discretion with billing information.
Able to present and manage cases in a knowledgeable and professional manner.
Must be able to communicate with people from all educational and cultural backgrounds.
Must cope constructively with stressful situations.
Must demonstrate tact, initiative, resourcefulness, professional manner, enthusiasm, and non-judgemental attitude.
Documents clearly and efficiently.

Responsibilities

Perform follow up with Commercial insurance companies on unpaid insurance accounts identified through claims report in CollaborateMD.
Utilize CollaborateMD and KIPU to research, investigate and record findings to get claims processed and paid properly.
Assist with submitting claims, follow-up of claims, and initial billing setup of clients.
Must have written appeals process experience
Responsible for applying Single Case Agreements to an account during the collections process. Must be able to identify the difference between electronic and paper submissions in CollaborateMD.
Responsible for applying benefit verification information to the collections process.
Ability to handle a large volume of outbound insurance calls for the purpose of claims follow up.
Responsible for entering detailed notes that clearly follow the claims process from submission to final posting, including Explanation of Benefits (EOB) Page 1 reconciliation, processing denial of claims and providing required documentation.
Responsible for collection and/or re-submission of claims by communicating information to supervisor and biller in a timely manner.
Prepare appeal letters on company letterhead
Communicate with the Strategic Revenue Cycle Manager to identify and resolve audit review issues.
Communicate daily with insurance companies via phone and written communication to answer/respond to correspondence related to patient accounts and answer billing and change related inquiries;
Maintain patient information confidentiality pursuant to HIPAA compliance.
Attend designated staff and in-service meetings.
Any additional duties as assigned by the management team.