Remote Billing Specialist, Berea or Toledo, OH (Ohio Residents Only)

Your story. Our mission. A perfect match.

Your story. Our mission. A perfect match. You have a place at OhioGuidestone, the state's leader in behavioral health! OhioGuidestone is the state’s leader in community behavioral health care, serving around 26,000 Ohioans each year. We focus on the needs of the whole person by providing telehealth and in-person prevention services, as well as mental health and substance use treatment. As we help people navigate the most difficult times in their lives—with compassion and respect—we ultimately empower them to take steps towards a healthier future.

Duties/Responsibilities:

• Responsible for completing all aspects of the revenue cycle, including, but not limited to;

• Submits billing for processing in a timely manner as dictated by supervisor or per each contract or grant, and provides reports to management.

• Conducts appropriate claims tracking and resolution.

• Monitors reimbursement to ensure accurate claims payment, conducts analysis and research to appropriately appeal denied claims, ensures appeals are filled timely, and assumes responsibility for conducting the appeals process when required.

• Maintains payer communications files, responds to inquiries from payers and patients regarding insurance claims status, and submits appropriate rebilling.

• Maintains cash sheets in date order and ensures that each are accounted for every month.

• Assists in maintaining compliance with current governmental and payer regulations.

• Verifies benefits with Medicaid, commercial insurance companies, the Mental Health Boards and other payers or funding sources to obtain client benefits and funding information and communicates information obtained to clients and/or staff.

• Maintains client financial and communication records and ensures that all necessary paperwork is accounted for.

• Determines ability to pay and facilitates collection of co-pays, deductibles, and private pay balances.

• Coordinates with Fintake staff during routing of agency referrals to ensure efficiency and accuracy of information.

• Obtains enrollments with the local board for reimbursement and follows up on outstanding requests.

• Collaborates with clinical staff to obtain and maintain authorizations for services.

• Runs receivables report monthly and performs follow-up to ensure payment is received and A/R is maintained within established guidelines.

• Runs Billing and A/R reports for validation and audit purposes.

• Submits electronic claims daily and prepares and submits paper claims as needed.

• Posts payments to client accounts and performs collections activities on past due accounts.

• Reconciles client accounts and recommend adjustments as appropriate.

• Performs audit of claims in accordance with policy/procedure.

• Prepares monthly invoices in accordance with grant and funding requirements.

• Monitors contract utilization for compliance with agreements.

• Coordinates with program staff to ensure that funding requirements are met.

• Creates and processes electronic invoices from billing software.

• Maintains a file for each contract with billing documentation and contract information.

• Escalates Billing/Accounts Receivable questions or concerns to the Team Lead.

• Develops and maintains processes to increase the efficiency of the Billing department.

• Must maintain regular and reliable attendance to the satisfaction of management.

• Exhibits positivity, flexibility and a willingness to take on new responsibilities as requested or required.

• Demonstrates positive leadership, promote a team-based work environment and present the Agency in the most positive light with all internal and external contacts.

• Employee may be asked to complete related duties other than those indicated above as assigned by their supervisor.

Required Skills:

• Must be able to operate a computer and other position related technologies.

• Must be able to verbally exchange information in a confidential manner with employees, clients, students, participants, and/or families in various settings.

• Must be able to dictate with clients, students, participants, co-workers, and supervisors using all means of communication including but not limited to, in-person, phone, and computer.

Performance/Physical Requirements:

• Must have analytical ability to be self-sufficient in performing essential functions.

• Must be able to remain in a stationary position 75%-100% of the time.

• Must be able to visually read written and digital information.

• Must be able to visually determine the accuracy, neatness, and thoroughness of work assigned and/or to make general observations of facilities or structures.

• Must be able to receive detailed information through oral communication.

• Must be able to clearly and confidentially communicate with OhioGuidestone employees, clients, students, participants, and other stakeholders.

• Must adhere to all Our Promise Values and Guiding Principles.

Qualifications:

• High School Diploma or GED required.

• Medical Billing Certificate preferred.

• 2 or more years of experience in billing with knowledge of commercial insurance and Medicaid policies and benefits, required.

• Knowledge of CPT, HCPCS, and ICD-9/ICD-10 coding, as well as requirements for federal and Ohio billing regulations, and third party insurance requirements required.

• Must have a valid Ohio Driver’s License with a safe driving record and valid insurance.

• Ability to take and pass a physical exam and drug screening.

• Employment is contingent upon clear results of a thorough background check.

Benefits include:

• • Free CEU trainings

  • Competitive benefits including a zero-cost monthly medical option for employee or employee children!

  • 10 paid holidays; three are exchangeable

  • Flexible work schedules to support work/life balance

  • Flexible work opportunities to support varying career paths, job roles, intern-to-hire, and locations

  • 401(k) with employer match option

  • Employment Assistance Program (EAP)

  • Mileage reimbursement

  • Recognition and rewards

At OhioGuidestone we care about the health and safety of our employees. OhioGuidestone requires applicants to complete a pre-employment screening process upon receipt of an offer of employment. We require and cover the cost of a fingerprint background screening, physical, Tuberculosis test, and drug screen after an employment offer is made. Any employment offer is contingent upon receipt of all satisfactory pre-employment screenings.

Committed to creating a more diverse community, we encourage candidates from historically underrepresented groups to apply. EEO/M/F/H/V