Insurance and Billing Specialist

The Insurance & Billing Specialist position serves as a key role in improving the overall effectiveness of revenue cycle collections. The applicant will preferably have a 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 also be an important resource for troubleshooting issues that clients may have.

The job responsibilities include but are not limited to:

• Determination of client eligibility, including any need for prior authorizations
• Proper setup of client insurance within EMR upon client intake and insurance updates
• Review, process, and correction of claims in various stages of revenue cycle in a timely manner.
• Act as a liaison for clients with questions or issues
• Produce 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
• Contribute ideas for proper and efficient setup of payer definitions within the EMR

Qualifications:

• Experience working with third party payers preferably in a community mental health environment
• Experience in claim follow-up in a healthcare practice environment preferred.
• Experience working with an EMR system and knowledge of payer definition and setup
• Knowledge of Medicare and Medicaid regulations and other insurance guidelines
• A basic understanding of direct service staff credentialing with third party payers as it relates to billing
• An understanding of healthcare billing to minimize the error rate in claim submission
• An ability to work both individually and as part of a team
• Experience with Excel preferable

Benefit Highlights:

• Competitive Pay
• Supportive/Flexible work environment with high employee satisfaction rates
• Generous Paid Time off & Holidays
• Medical, Dental and Vision, Group Life, FSA, HSA, and 401K plan

Concord welcomes all to apply!