Senior Business Services Analyst - Insurance Reimbursement Supervisor

Prince William County Community Services is looking for a motivated individual to join our organization as an Insurance Reimbursement Supervisor (Senior Business Services Analyst). We are a large community-based behavioral health organization. The position is responsible for the aggressive oversight and management of Aged Receivables, the import of 835’s (electronic payments) from the clearinghouse and Insurance portals as well as direct supervision of 3 employees. Ensure compliance with all payer regulations, timely filing requirements and participate in monthly Insurance payer meetings. Must have computer skills to be proficient with various computer applications, proficient in Microsoft Office utilized in the course of duties. Strong communication and interpersonal skills are required to work with professional staff and clients. Individual must demonstrate problem-solving, analytical, and sound judgement skills

About This Role

This position will directly supervise and support 3 staff and be responsible for the oversight and management of the Insurance Aged Receivables and the import of all electronic payments into the E.H.R. for all Outpatient and Community Mental Health Rehabilitative services. Responsibilities include the following:

• Daily import of electronic payments from the clearinghouse and Insurance portals
• Daily upload of electronic payments into the E.H.R.
• Distribution of Electronic payments for posting to reimbursement staff
• Daily Coding of electronic payments and payments via the mail with the appropriate chart of Accounts
• Oversight of electronic and paper claim submission to ensure timeliness for assigned payers
• Review of unworked claim edits and rejections
• Review, Analyze and determine denial trends and billing matrix errors on unpaid services
• Oversight of reimbursement staff to ensure the aged receivables are being worked aggressively
• Oversight of the Authorization process to ensure authorizations are being requested, and submitted in a timely manner
• Review reimbursement process for efficiency and effectiveness
• Stay abreast of Insurance and Medicaid payer changes and regulations to ensure compliance
• Oversight of daily deposit audits
• Participation in monthly meetings with Medicaid and Insurance payers
• Monthly/weekly supervision of 3 staff and completion of annual evaluations
• Ensure agency compliance with all state, federal, and government billing regulations. Other duties as assigned.
  
  

Minimum Requirements

High School Diploma or GED

Five years of Insurance billing, posting and/or collection experience

Preferences

Working knowledge and experience with filing Electronic Claims to Insurance payers

Experience with Aged receivables management

Must have computer skills to be proficient with various computer applications

Knowledge of 835 (electronic payments) and importing payments from a clearinghouse

Knowledge of ICD10 and CPT coding

Supervisory, training/mentoring experience

Experience with computerized accounting systems and proficiency with PC's and associated software applications utilized in the course of duties.

Knowledge and experience with claims submission for Behavioral health and Early Intervention services

Experience working with a CSB

Experience with Credible.

Special Requirements

Must possess a valid driver's license. Must pass DMV record check. Must pass TB test. Offer of employment is contingent upon the candidate passing a fingerprinted-based national criminal history record check. Child Protective Services Requirements: Effective 1999, mandated by the Department of Behavioral Health and Developmental Services 12VA35-105-400 rules and Regulations for Licensing Providers by the Department of Behavioral Health and Development Services related to Criminal Registry Checks, a search of the registry of founded complaints of child abuse and neglected maintained by the Department of Social Services.

Work Schedule: No teleworking. Monday – Friday 8:30-5:00

Location: 7969 Ashton Avenue Manassas, VA 20109

Starting Salary Range: 70,921.50 – 97,968.00

Prince William County Community Services maintains a drug free workplace.

Note

The above position description is intended to represent only the key areas of responsibilities; specific position assignments will vary depending on the business needs of the department.

To view the class description in its entirety, click here.

Prince William County is an Equal Opportunity Employer.

In compliance with the Americans with Disabilities Act, the County will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer.

Our Benefits...

• Excellent Pay
• Paid accrued annual and sick leave
• 11 paid holidays
• 4 paid personal days
• Optional, comprehensive health care plans
• Life Insurance
• Employee Assistance Program
• Access to online courses
• Virginia State Retirement
• 401a and 457 Retirement Savings Plans
• Credit Union eligibility
• Job security
• Opportunities for career growth, advancement specialization
  
  

Prince William County Government full-time positions qualify for Public Service Loan Forgiveness. Click here PSLF for more information.