Contract Billing and Reimbursement Specialist - Wallingford, United States - Aware Recovery Care

Aware Recovery Care Wallingford, United States

3 weeks ago

Description

Job Description

Job DescriptionAre you interested in joining a dynamic company that delivers successful in home treatment to clients with substance use disorder? If you are a caring, compassionate and capable Billing and Reimbursement Specialist who meets or exceeds the following, we want to hear from you

Position Summary:
The role of the Billing & Reimbursement Specialist is to analyze the claim submissions and billing process to determine appropriateness and accuracy. The Billing & Reimbursement Specialist is responsible for handling claims processing including Accounts Receivable aging/collections and reviewing returned, disputed or rejected claims from commercial payers.

Role Expectations:

This role is remote, up to 16 hours per week. Candidate must reside in one of the following states CT, FL, GA, IN, KY, ME, MA, NH, OH, RI, VA, NJ, NY, AR, MN, PA, TX
This is a contracted 1099 position.
Weekend availability preferred
The starting hourly rate is between $20-$25/hour

Aware Recovery Care is an Equal Opportunity Employer

Responsibilities
Reasonable Accommodations Statement
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform the essential function

RESPONSILITIES:

Ability to assess and track why payments are being billed incorrectly and appropriately create mitigation strategies to reduce additional risks.
Work with external and internal staff to ensure on getting all claims paid in a timely manner.
Obtain reimbursement from responsible parties by direct contact as needed to facilitate reimbursement.
Manage a large number of accounts and claims.
Ability to work 300 minutes on the phone/portal for claims adjudication.
Manage claims via multiple platforms and systems.
Ability to negotiate claims and resolve claims with external agencies.
Ability to identify Verification of Benefits (VOB) issues as it pertains to claim resolution and resolve the issue or report the issue.
Ability to assist with cash posting, posting charges, and/or assist with daily, weekly and monthly closing, as needed.
Run claims, and cash posting reports daily, weekly, monthly and quarterly as assigned.
Identify and communicate with payer and/or system trends to Management regarding unpaid claims, denials, reimbursement issues, etc.
Maintain thorough knowledge of payer contract, regulations and guidelines, as well as State and Federal laws relating to reimbursement procedures to ensure accurate and compliant billing processes.
Take initiative and action to respond and resolve customer billing and reimbursement inquiries in a timely manner.
Initiate payer disputes, initiate appeals and exhaust all internal collection efforts.
Make recommendations for collection trends.
Outbound phone calls to payers.
Outbound phone calls to clients.
Collect on accounts and troubleshoot all inquiries from the organization and other entities based on insurance carrier information rules and regulations.
Accountable for outstanding customer service that drives quality and an exceptional customer experience.
Adapts to organizational change and departmental restructuring to fit the needs of our clients and payer sources.
Perform miscellaneous job-related duties as assigned.

Required SkillsPOSITION QUALIFICATIONS:

High School graduate or equivalent
Minimum two years of previous healthcare billing and reimbursement
Knowledge of CMS 1500, CPT codes and ICD-10
Knowledge of 837 billing processes and 835 processes
Proficient keyboarding and computer skills including word processing, spreadsheet, and Client Accounts software

Key Competencies:

Exceptional organizational and leadership skills
Efficient work ethic
Ability to easily adapt and multitask
Strong ability to collaborate and perform in a team-oriented environment as demonstrated by prior experience
Professional and proficient written and verbal communication
High level of integrity and professionalism
Goal and results oriented
Resilient and able to perform under pressure
Critical thinker
Reliable
Strives for excellent standards of quality
Entrepreneurial spirit
Commitment to ongoing learning and growth
Ability to use electronic health records, phone systems, customer resource management software, and more general office computer systems
Appreciation and respect for principles of diversity, equity, and inclusion. Ability to engage with diverse audiences (age, gender, nationality, race/ethnicity, profession, etc.)

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