- 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.
- Possession of a valid driver's license with a good driving record.
- Must have automobile liability insurance and access to a safely maintained car.
- 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.
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Mental Health Billing and Collections Specialist - Canton, United States - Pathway Caring for Children
Description
Job Description
Job DescriptionLocation: 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:
Other Requirements:
Responsibilities:
The Mental Health Billing & Collections Specialist will report to the Accounting & Billing Supervisor and work from the Central Office of Pathway. Responsibilities include:
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.
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