Far West Center is an award-winning community mental health center located in Westlake, Ohio, serving both Cuyahoga and Lorain Counties with a comprehensive ranges of mental health and recovery services. We have an outstanding opportunity for an experienced Billing and Reimbursement Specialist.
Responsibilities of the Manager, Billing and Reimbursement :
- Prepares and processes healthcare claims for outpatient mental health services to Medicaid, Medicare, County and commercial insurance payors.
- Assures the accuracy of payor data; verifies insurance coverage and benefits for patients, including deductibles, co-payments, co-insurance, and prior authorization requirements.
- Post payments from payors, including patient payments, and reconciles patient accounts.
- Researches and resolves claim denials to assure full and complete payment on clean claims.
- Prepares and sends patient account statements for balances owed.
- Prepares reports on claims status, aging accounts, and other trends identified with insurance payors.
- Assists with payment arrangements with patients when necessary.
- Liaison with insurance and managed care companies to resolve claims issues and assure timely, correct claims filing.
- Guides Far West Center providers around payor requirements.
- Assists with provider credentialing as needed.
- Coordinates work with intake/access staff and client service representatives to assure accurate and updated client information.
Qualifications and Requirements for the Manager, Billing and Reimbursement Specialist:
- Three (3) years recent experience in healthcare billing, preferably in a behavioral health or outpatient clinic setting.
- Extensive, recent knowledge of insurance payors including Medicaid, Medicare, managed care and insurance plans.
- Knowledge of CPT coding, diagnosis coding, and medical terminology as needed for claims processing.
- Ability to submit, download and post claims and payments electronically; EDI experience needed.
- Must demonstrate high initiative and accuracy in performing duties of this position.
- Ability to enter and manage payor and claims data in an electronic health record.
- Knowledge of payor credentialing requirements and eligible service providers.
Compensation for the Billing and Reimbursement Specialist:
An excellent salary and benefits package is offered, along with an opportunity to work in a team environment dedicated to service quality in all we do.
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
