Outpatient Mental Health - Billing Specialist

Summary

As an Outpatient Mental Health Billing Specialist, you will be essential in managing the financial aspects of patient care regarding the accuracy of medical billing, initiation and maintenance of credentialing for new and current providers, knowledge of CPT codes in addition to the ICD-9 and the ICD-10. You must be able to utilize your core skills in medical billing, EHR systems, insurance benefit verification, and medical terminology to process claims efficiently and handle all denials. Your role will be crucial in solidifying the financial flow of the company and maintaining the integrity of best billing business practices.

Job Requirements

• Coordinates, monitors and maintains the credentialing and re-credentialing process, ensuring that the appropriate and designated staff files stay up to date and are current.
• Process agency wide provider and agency enrollment, credentialing, and revalidation through CAQH.
• Manage payer-provider roster updates and practice information requests.
• Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
• Compiles and maintains current and accurate data for all licensed healthcare professionals.
• Accepts and processes all requests from payers for credentialing information, updates.
• Answers questions, process requests from staff/providers related to credentialing information.
• Monitors and reports turnaround times for processing of credentials applications, with continued focus on delivery of a high-quality output, with the greatest efficiency, in the least amount of time.
• Files applicable provider practice change notifications and performs follow up duties until confirmed complete by payers.
• Updates facility and provider NPI records according to provider specifications.
• Ensures that established executed contracts are properly maintained and circulated as necessary.
• Completes applications and maintains all information up to date in Council for Affordable Quality Healthcare (CAQH) for all providers and facilities and attest providers as needed.
• Responsible for credentialing of facilities and providers for insurance companies.
• Effectively manage clearinghouse claims issues.
• Contact insurance providers to validate the verification of insurance benefits for potential new clients.
• Process billing claims with the intent to get the maximum reimbursement allowed for services rendered.
• Manage the reprocessing of denied claims.
• Research/Investigate/Resolve and communicate complex insurance benefit eligibility issues.
• Maintain and provide direct reporting supervisor with reports on billing and credentialing updates and statuses
• Ability to be volume claims for Commercial and NJ Medicaid insurance
• Has knowledge of behavioral health billing and CPT codes
• Apply copayments, deductibles, and coinsurance to client charts
• Effectively communicate your needs when having issues with insurance providers
• Return all calls and emails in a timely manner
• Perform other tasks assigned by the supervisor

Qualifications

• Proven experience in medical billing and collections
• Proficiency in CPT coding and understanding of ICD-9 and ICD-10 coding systems
• Familiarity with EHR systems and medical office operations
• Strong knowledge of medical terminology and medical records management with regards to Behavioral and Mental Health
• Strong knowledge of Managed Care Payer rules and regulations.
• Versed in Third-Party Payer, Commercial Insurance Companies, NJ Medicaid, and Medicare billing and payment procedures
• Provider credentialing processes and procedures
• General competence with computer systems
• Working experience with billing clearinghouses

Job Types: Full-time, Part-time, Contract

Pay: $20.00 - $30.00 per hour

Expected hours: 20 – 40 per week

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Evening shift
• Monday to Friday
• Night shift
• Weekends as needed

Work Location: In person

Salary : $20 - $30