JOIN OUR TEAM!As a part of our team, the Billing and Claims Specialist is responsible for following up on receivables from third-party payers and performing patient collection activities. This position requires a solid working knowledge of patient collections, payer requirements, appeals, denial codes, corrected claims, and speaking with patients about their balances. WHAT YOU'LL DO:
- Patient Collections
- Research patient account disputes and billing discrepancies and follow up with patients as needed. Maintaining professional communication is critical.
- Set up patient payment plans via phone and in-person; obtain and process client payments by credit card and/or check.
- Process returned patient statements due to bad address.
- Identify patients with upcoming appointments who have delinquent accounts. Attempt to reach the patient prior to their appointment to collect payment.
- Assist patients with setting up payment arrangements and with completing funding applications for Iowa Medicaid and Eastern Iowa Mental Health Region, as needed.
- Make collection calls to patients and document daily collection activities. Track all calls and conversations; maintain documentation sufficient to prevail through collection process.
- Identify delinquent accounts requiring external collection efforts, compile list to upload to external collection agency, and monitor collection status.
- Identify bad debt or financial exposure and submit information/report to the Revenue Cycle Manager no less than bi-weekly.
- Insurance Receivables
- Work with payers (Medicaid, Medicare, commercial insurance, worker's compensation, VA/Tricare, county offices, etc.) to ensure timely claim payment. Responsible for follow-up on unpaid claims and EOB review to ensure correct payment and/or denial. Take prompt action as necessary to obtain payment on unpaid/underpaid claims.
- Stay abreast of Medicare and other payer requirements and guidelines for continued successful reimbursements. Resolve account non-payment issues resulting from invalid coding, missing documentation, and/or other miscellaneous reasons for non-payment of claim.
- Other Functions
- Perform other functions of the billing team as necessary to ensure adequate back-up and to ensure all essential functions are performed. Performs eligibility verifications at the first of the month with other team members.
- Billing team members may change areas of focus as work/receivables evolve; any of the functions of the team: eligibility verification, preparing charges and submitting them, posting payments, receivable collections, reporting, deposit preparation, testing the system or any other function that falls within the billing team duties may be assigned to any team member.
WHAT YOU'LL NEED:
- High School Diploma or GED required, Associates degree, coding certification, or equivalent experience with medical claims processing preferred
- Minimum 1 - 2 years of relevant medical claims processing, accounting, or accounts receivable experience
- Strong communications and interpersonal skills are essential; extremely good telephone manners are necessary
- High level of attention to detail and accuracy
- Exhibits a high level of professionalism and ethical behavior. Demonstrated ability to handle confidential information in a professional, time sensitive manner
Share Our Values: We are united by our shared values of community service, compassion, empowerment, respect, resourcefulness and professionalism. Make an Impact: Our mission is to enhance the mental health of all in our community by providing quality, accessible and comprehensive care.Learn and Grow: Vera French offers various in-house training opportunities CPR, Medication Management and other trainings through our learning management system. To encourage our staff to continue their education, Vera French also offers a Tuition Reimbursement and Loan Repayment program for all employees after one year of employment. WHAT WE OFFER:
- Group Health, Dental and Vision insurance
- Wellmark Blue Cross/Blue Shield health insurance
- Delta Dental - dental and vision insurance
- Employer paid life Insurance, AD&D, LTD through Mutual of Omaha
- Supplemental life insurance, short term disability available
- 401(k) with employer contribution & matching
- Employer contribution 3% of annual salary, vested day one
- Employer matching 25% of every dollar put in by the employee, up to 6%
- Tuition Reimbursement & Loan Repayment Program
- Every employee (full-time or part-time) is eligible after one year of service
- Supplemental Critical Illness and Accident Coverage through Mutual of Omaha
- Paid time off
- Nine paid holidays per year
- Nine paid sick days per year accrued on a payroll basis
- 2 weeks of vacation accrued on a payroll basis
NOTIFICATION AND AUTHORIZATION TO REQUIRE A MEDICAL EXAMINATIONI hereby certify that, if hired, I will disclose any limitations I have that may impact my ability to do the job. I understand that I may also be required to undergo a pre-employment or post-employment medical exam by the VFCMHC' designated health practitioner.NOTIFICATION AND AUTHORIZATION TO CONTACT REFERENCES AND CONDUCT BACKGROUND INVESTIGATIONI understand that I may be subject to a background check, and hereby authorize Vera French Community Mental Health Center, or any of its affiliates, to investigate my background to determine any and all information of concern as to my record, whether the same is of record or not, and I release employers and persons named in my application from all liability for any damages on account of his/her furnishing said information.Additionally, you are hereby authorized to make any investigation of my personal history, educational background, military record,motor vehicle records, criminal records, and credit history through an investigative or credit agency or bureau of your choice. Iauthorize the release of this information by the appropriate agencies to the investigating service. I authorize and give permission forthe individuals listed as references to provide written information and/or verbally discuss my background with Vera FrenchCommunity Mental Health Center, or any of its affiliates.This authorization, in original or copy form, shall be valid for this and any future reports and updates that may be required.I understand that passing the background check is a condition of employment. A negative background check can be grounds fordismissal, even if an offer has been made to me and I have been hired.