Benefits and Billing Specialist

Benefits and Billing Specialist

Grand Junction, CO

One Full-Time Position. 40 hours per week.

Monday through Friday, traditional hours.

Hiring Range: $21.00 - $22.89 / hr., depending upon education and experience.

This position will remain open until filled.

Minimum Requirements

Required:

• High School diploma or equivalent, minimum age 18.
• Advanced computer skills in Microsoft Word and Excel.

Preferred:

• Prior experience in benefit utilization analysis.
• Experience with the Medicaid Waiver process.
• Experience with Electronic Record Management systems (eg. Simple Practice, Therap, Extended Reach).

We care about our team! At Ariel we offer an expansive benefit package:

Subject to Eligibility.

• Medical, Dental, Life Insurance Premiums are 100% covered by Ariel, which averages to an additional $4.80/hour to your total compensation!
• HSA & HSA employer contribution
• FSA
• Vision
• Generous Paid Time Off accrual - 13 PTO days in the first year, 48 hours of paid sick leave, and 11 paid holidays. Total of 30 paid days off in the first year.
• $50/month; $600/year with Lifestyle Spending Account
• Life Insurance, Disability Insurance, Legal & ID Shield through MetLife
• Retirement 403B & 403B employer match up to 4% at one year anniversary
• Mileage Reimbursement
• Employer provided work phone and computer
• Employee Assistance Program (EAP)
• Wellness Program
• And committed to a Culture of Awesomeness!

Position Summary

The Benefits and Billing Specialist is responsible for ensuring accurate and efficient management of benefits, billing, and related processes for individuals receiving services. This role involves managing SSI benefits and other federal/state benefits for members receiving services, processing billing, and ensuring compliance with rules and regulations.

Ariel Clinical Services Mission

To provide safe, nurturing and supportive environments for children, families, and adults so that they may have the opportunities to develop their strengths, maximize their potentials and fully participate in society.

Essential Duties and Responsibilities

1. Ensure accuracy and timeliness in benefit processes. Ensure all billing practices comply with relevant rules and regulations by meeting deadlines set by Medicaid, Medicare, Social Security Administration, and internal practices.

2. Ensure Medicaid redeterminations, County Redeterminations (LEAP, SNAP), and other insurances (e.g., Part D), and Social Security Administration paperwork are completed accurately and on time.

3. Assist and provide guidance to individuals in understanding and applying for Social Security, Medicaid, HCBS Waiver, and/or other benefits.

4. Work with individuals receiving services to establish and manage appropriate trust funds.

5. Collaborate with local agencies to optimize benefits and stay informed about process changes.

6. Ensure accuracy and timeliness in the billing processes by preparing billing and following up on denials. Ensure all billing practices comply with relevant rules and regulations.

7. Review and process prior authorization requests (PARs). Submit PARs requests for programs and follow up as needed. Provide clear and concise information regarding status, address and resolve any issues prior to services starting. Monitor utilization and coordinate PAR revisions to maintain adequate funding.

8. Collaborate with accounting department to develop, implement, and maintain agency-wide SOPs for billing processes.

9. Communicate effectively and efficiently with team members, supervisors, and coordinators.

10. Work with individual teams to resolve insurance issues for individuals receiving services.

11. Collaborate and work closely with accounting and other Ariel departments to coordinate benefits and billing processes. Collaborate with external agencies and organizations as needed. Participate in ongoing program evaluations to ensure billing effectiveness.

Additional Duties and Responsibilities

1. Must work closely with other Ariel programs.

2. Performs other duties as assigned.

Required Knowledge, Skills and Abilities

1. Ability to maintain a positive outlook.

2. Ability to represent Ariel Clinical Services in a positive and professional manner.

3. Ability to build and maintain positive relationships with coworkers, providers, funding sources, etc.

4. Ability to maintain a high level of confidentiality concerning the client, their family, background and treatment.

5. Knowledge of rules and regulations related to Adult Service Agency (ASA) clients is required.

6. The ability to effectively communicate verbally and in written format in both individual and group settings.

7. Ability to be flexible, and able to change direction rapidly.

8. Ability to work independently, prioritize workload, complete a wide variety of tasks in a timely and accurate fashion and direct others, as needed.

9. Advanced computer knowledge, especially with Excel, Therap, and Medicaid processes.

10. Ability to exercise independent judgment within the scope and boundaries of the ASA department, the Agency’s Standard Operating Procedures, and Federal, State and Local Rules and Regulations regarding program operations.

11. Knowledge of basic tenets, interventions and evaluation formats of intensive community-based services.

12. Ability to demonstrate consistent and reliable attendance as scheduled and requested

Education and Experience

Required:

• High School diploma or equivalent, minimum age 18.
• Advanced computer skills in Microsoft Word and Excel.

Preferred:

• Prior experience in benefit utilization analysis.
• Experience with the Medicaid Waiver process.
• Experience with Electronic Record Management systems (eg. Simple Practice, Therap, Extended Reach).

Certifications/Licenses

None

Supervisory Responsibilities

None

Physical Demands

1. This position requires that the incumbent be capable of sitting, stooping, stretching, and/or reaching regularly for periods up to two hours without a break.

2. This position requires that the incumbent have adequate hand and finger dexterity to properly perform the functions of the position.

3. This position requires lifting regularly up to 10 pounds.

4. This position requires the ability to hear and see, at a level which is adequate to ensure client and staff health and safety. Adaptive devices are acceptable.

Work Environment

Will work in the office or in a personal home environment.

Required Background Checks & Documentation

1. Criminal Background Investigation (CBI)

2. Colorado Adult Protective Services (CAPS)

3. CBI Sex Offender Background Check

4. National Sex Offender Background Check

5. Reference check

6. I-9 documentation

7. Office of Inspector General