Summary
Under the supervision of the Division Director, staff will manage the billing system and team. Duties include but are not limited to: input data for IBHIS, Exym, Server, and other outcomes data, and generate weekly/monthly denied claims/cost/revenue reports.
Essential Functions
Manage and troubleshoot EHR/Information System in accordance with DMH protocol.Review, manage, and develop billing procedures as needed to maintain compliance with local, state, and federal regulations and streamline operations.Coordinate revenue report, invoices and billing for partner agencies.Track denied claims for denied codes and provide weekly status update of each denied claim. Troubleshoot any billing issues with denied claims.Identify and notify management of denial patterns and issues.Prepare financial reports related to billing activities for management review.Track voided claims and update Void Claim Reason Collection (VCRC) on a weekly basis.Manage, track and resolve denied and voided claims, following through until claim is paid. Provide weekly updates until resolved.Recruit, hire, train, and supervise all billing team members.Understand how mental health staff in electronic databases (NAPAA, NPPES) affects billing accuracy and completion.Attend internal and external meetings and trainings.Develop and maintain claim resolution skills through continuous trainings, workshops, and education.Maintain and execute confidential information using HIPAA standards.Monitor insurance status of clients and send monthly updates to DMH.Perform other tasks and responsibilities as assigned by the Division Director and/or Program Managers, and Program Coordinators.Provide linkage with other health facilities (pharmacy, lab, medical offices, partners).Provide timesheet approval report at the end of each pay period.Manage and resolve error corrections for Alliance claims and activities.Update NAPPA of staff information.Set up and update Exym accounts for staff.Provide weekly report for denied claims/OHC, related items and update status on resolution.Provide monthly productivity reports to program managers.Collaborate with QA team to oversee the electronic health record, Exym, for billing, case closures, location, funding sources and productivity updates.Regular attendance.Other duties as needed.Minimum Qualifications - Knowledge, Skills and Abilities Required
Bachelor's Degree in business field or another related field.Minimum 2 years of experience in Behavioral Health billing, minimum 5 years total billing, and at least 2 years in a supervisory role.Knowledge: Strong proficiency in use and application of Current Procedural Terminology (CPT) Codes; Strong proficiency in computer software programs (Experience on Microsoft Word and Excel, Internet; Medi-Cal, Medicare, private insurance etc.).Skills: Strong writing and oral (communication) skills; Strong interpersonal and social skills; Time management skills necessary; Strong analytical skills, problem-solving abilities, and sharp attention to detail; Excellent data management skills.Abilities: Ability to develop and maintain effective working relations with program and community representatives and contractors; Ability to work both independently and as a member of a team.Bilingual skills preferred but not required.Verification of Employment Eligibility and Background Check.
Supervisory Responsibilities: Manage and lead the billing team, providing guidance and support as needed.
Physical Requirements: The employee is expected to sit, stand, walk, carry a maximum of 20lbs, listen, and speak in order to complete job requirements.
Mental Requirements: The employee must be able to handle any/all of the following: constant distractions, interruptions, uncontrollable changes in priorities/work schedules; be able to process information, think, and conceptualize.
Job Type: Full-time
Pay: $31.00 - $36.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid sick time
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: In person
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