This position works under the supervision of the Controller. Responsibilities include following insurance claims through the full billing cycle from submission to appeals as well as client statements and follow-up for a set group of payers. This position requires clear understanding of the rules of confidentiality, the ability to exercise sound judgment, and knowledge of the behavioral health vocabulary.
Submit billing to various insurance companies and post payments within timely limits.
Resolve clearinghouse claim edits within timely limits.
Follow-up on denials and submit appeals to insurance companies for payment within timely limits.
Acquire benefit coverage in regards to behavioral health and obtain authorizations.
Communicates patient benefits to staff and consumers appropriately.
Work various reports; collections, aging, reconciliations, service pended, and closed client reports.
Correct set up of patient billing, follow-up and resolve of billing issues.
Work with billing department staff in a team-oriented approach.
Interact with internal and external agencies in a professional and customer friendly manner.
Able to prioritize and work independently.
Back up in the department for other positions.
Requires knowledge of medical billing and collection practices/procedures for commercial insurance companies, Medicare and Medicaid.
Experience with the overall billing process: claims- electronic and paper, authorizations, payment posting, CPT coding, benefit verifications, EOB's and ERA's.
Excellent computer and customer service skills are required. Excel experience is required.
Experience with aging reports and general ledger reconciliations.
Basic Accounting skills.
Able to contribute and be part of a team
Jefferson Center For Mental Health