Billing Specialist - Denials (9009)

Billing Specialist - Denials

Fairfield, OH

Are you looking for a career where you can make a difference in the lives of individuals in recovery for mental health and substance use disorders? Do you thrive in a healthy and collaborative work environment where you can grow personally and professionally?

JOIN OUR TEAM of dedicated professionals in fostering hope and transforming lives.

Develop a career dedicated to connection, compassion, and community. Community Health Alliance is an employer that offers career opportunities with purpose.

Summary

As a Billing Specialist you will be responsible for managing the billing and accounts receiving functions, specially payment denials. Your primary goal will be to ensure accurate and timely billing, prior authorizations and appeals of denied claims to facilitate payment for services.

This is a hybrid position that requires 90 days of in office training. After successful completion of training, eligibility to work a hybrid remote/in-office schedule.

We are proud to offer a comprehensive benefits package:

• Affordable medical, dental and vision insurance
• Company paid Health Reimbursement Arrangement (HRA)
• Generous paid time off (PTO) & paid holidays
• Retirement plan with company match up to 6%
• Career ladder Start here and build a lifelong career
• Company paid life insurance

Job Duties and Responsibilities

• Thoroughly review and understand Explanation of Benefits (EOBS).
• Thoroughly understand claim denials and proper steps to resolve issues.
• Utilize payer websites and dedicated call centers for claim status and to review claims submitted.
• Call insurance companies regarding any discrepancy in payments as necessary.
• All accounts are to be reviewed for insurance or patient follow-up.
• Review and follow up on claim denials timely and take appropriate actions to resolve claims.
• Review claims submitted for accuracy and submit corrected claims as needed.
• Update demographic and insurance information in the billing system.
• Provide feedback on claim payments to ensure the fee schedule is accurate.

• High school diploma.
• Minimum of 3-5 years of behavioral health billing and follow up experience.
• Strong understanding of working accounts including, MCO, Medicaid, PPOs Medicare.
• Experience in filing claim appeals with insurance companies.
• Knowledge of CPT and HCPCS coding; familiarity with medical terminology.
• Ability to manage relationships with various insurance payers.
• Recent experience working on payer websites to look up claim status, submit appeals,
• Recent experience working accounts including billing, collections, denials, and appeals.
• Ability to calmly handle multiple tasks at once.
• CareLogic experience preferred.

Community Health Alliance is a leader providing the highest industry standards for health and human services. Our agencies of Sojourner Recovery Services and TLC offer a complete continuum of mental health and substance use treatment services. We equip our patients with the resources, services, and tools they need to achieve their goals and reach their highest personal potential. Community Health Alliance is proud to play a key role in helping individuals achieve a brighter and healthier future. Through innovation, integration, and collaboration of our agencies, the Community Health Alliance strengthens and empowers the individuals, families, and communities we serve.

Community Health Alliance is a drug testing Equal Opportunity/ Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Key words: billing, revenue cycle, denials, prior authorizations, payment, payers, insurance, healthcare, compliance, data analytics, customer service, communication, organizational skills, problem solving, teamwork, interpersonal skills, flexibility, dependability, initiative, motivated, analytical skills, detail-oriented, planning, results-oriented, computer skills.