Mental Health Billing And Collections Specialist

Location: Canton, OH

Job Type: Full Time

About Pathway Caring for Children:

Pathway Caring for Children is a nonprofit organization based in Ohio, United States. They specialize in providing a range of services for children and families in need, including foster care, adoption, mental health services, and behavioral health treatment. The organization is committed to supporting children's well-being and helping them thrive in safe and nurturing environments. They also offer support and resources for families to strengthen relationships and overcome challenges. Overall, Pathway Caring for Children plays a vital role in the community by promoting the welfare of children and families through their comprehensive programs and services.

Qualifications:

The successful applicant for this position must possess the following qualifications:

Education or Experience:

At least two years of post-secondary education or equivalent work experience (5 years or more) in medical billing, customer service, and/or collections.

Skills and Abilities:

• Ability to multitask, prioritize tasks, and meet required timelines.

• Proficiency in general office practices, organizational skills, and competence in Microsoft Office Programs.

• Effective communication skills with sensitivity and consideration for the cultural differences among the children and families served by Pathway.

• Working knowledge of ICD-10 coding, CPT, HCPCS, EOBs, ERAs, and medical terminology.

• Experience in Commercial and Medicaid billing related to mental health services is preferred.

• Excellent understanding of the medical billing process.

Other Requirements:

• Possession of a valid driver's license with a good driving record.

• Must have automobile liability insurance and access to a safely maintained car.

Responsibilities:

The Mental Health Billing & Collections Specialist will report to the Accounting & Billing Supervisor and work from the Central Office of Pathway. Responsibilities include:

• Claims Submission:

• Generate Weekly Incomplete Service Notes Report.

• Assist in appropriate claims coding.

• Collect all information necessary to prepare insurance claims and bill patients.

• Run Agency monthly eligibility.

• Verify accuracy of client billing data and revise errors prior to submitting to plans.

• Obtain and/or enter documents such as authorizations, financial agreements, and other necessary ancillary documents.

• Process the claim production report several times a week to force any claims that have been stopped.

• Process weekly and monthly billing in absence of Accounting and Billing Supervisor.

• Billing:

• Utilize CPT coding, ICD coding, and HCPCS in relation to mental health services medical terminology.

• Enter and update billing data into the electronic health record.

• Process all Mental Health Client billing.

• Generate report to post unbilled claims at month-end.

• Verify claims received by insurance companies.

• Review all payer rejects and correct rejected claims in clearing house and other insurance websites.

• Payment Posting:

• Review and process (post) EOBs/ERAs.

• Research, correct, and re-submit rejected and denied claims.

• Prepare claim appeals.

• Process credit card payments from clients and payments received from other offices through an online processing site.

• Minimize claim denials to maximize revenue.

• Understand copays, coinsurance, and deductibles.

• Resolve discrepancies in accounting records.

• Collections:

• Call to collect on client collection accounts.

• Provide the Controller and billing team with a monthly MH AR Aging report.

• Monitor aging reports and take necessary steps to guarantee payment of claims.

• Interact with staff, clients, payer, and agencies to answer questions, obtain information, and resolve issues.

• Recognize problem accounts and notify appropriate staff or supervisor for assistance.

• Update and send information to the Collections Attorney.

• Attend collection hearings as a Pathway representative.

• General Responsibilities:

• Assist Accounting & Billing Supervisor as needed.

• Maintain detailed records as required.

• Participate in billing auditing processes.

• Provide feedback for improved claims processes and performance, reduce errors, and improve quality assurance.

• Communicate and send reports to Enrollment, Clinicians, Therapist, and Directors.

• Work closely with the Controller to provide month-end reports.

• Anticipate insurance trends and advise supervisor of changes.

• Attend bi-weekly MH Billing Meetings and be prepared to discuss any trends, updates, reports, collections, and judgments.

• Other:

• Participate in in-service training designed to improve job knowledge or performance.

• Assist with providing coverage for the front desk.

• Attend regular team and supervision meetings with supervisor.

• Undertake special projects assigned by supervisor.

How to Apply:

Update your resume to reflect your relevant education, work experience, skills, and qualifications outlined in the job posting. Write a cover letter expressing your interest in the position and highlighting how your experience and skills make you a suitable candidate.

Pathway is a smoke free and drug free organization. All applicants must be able to pass a background check.