Lead Claiming Analyst - Mental Health Billing

JOB SUMMARY: Sycamores provides a spectrum of equitable mental health services through various programs to multicultural populations of all acuities. Although it serves a variety of consumers, the agency focuses primarily on providing care to low-income, high at-risk youth. The role of the Lead Claiming Analyst is to maintain claiming functionalities within the Electronic Health Record System (EHRS). The maintenance of the claiming functionalities within the Electronic Health Record System will include but is not limited to submission of claims, working denials, and processing voids.  DUTIES AND RESPONSIBILITIES:(These are the essential job functions for this position. The essential functions of this job include but may not be limited to those listed in this job description. Employees hired for this position must be able to perform the essential function of this job without imposing significant risk of substantial harm to the health or safety of themselves or others.) Verify insurance eligibility and benefits monthly or as needed. Pre-scrub services by notifying peers of potential claiming errors and ensure accuracy.  Monitor efficiency of systems, policies, and procedures. Make appropriate recommendations to ensure daily operations are efficient. Assist in the development and implementation of billing policies and procedures. Responsible for ensuring weekly submission of claims to the appropriate payor, including voids, denials, and resubmissions. It is the responsibility of the Lead Analyst to ensure all claims have completed all steps within Revenue Cycle. In collaboration with Claiming Analyst, claim, track, and monitor submitted invoices to payors. Verifies that claims have been submitted properly by performing a reconciliation to identify any discrepancies that may have occurred within processing. Monitor, analyze, correct, and resubmit claims to payor(s) in a prompt and accurate manner. In collaboration with the Manager, produce revenue and denial reports so that programs can implement strategies to improve revenue performance. Maintain proficiency in Sycamores EHR system and payor(s) systems in order to process claims.  Responsible for responding to claiming inquiries, such as progress note corrections, funding issues and program changes. Maintain the highest level of customer service when responding and collaborating with internal and external consumers. Work with payors and Health IT to ensure that most recent updates have been applied to EHRS. Participate in meetings and committees related to billing and revenue cycle management. Duties and responsibilities may be added, deleted, and/or changed at the discretion of management.   Starting Pay Range: $68,640 - $72,000 per year for Full-Time employment (starting pay will be based on previous work experience and educational background.) JOB QUALIFICATIONS AA Degree AND/OR at least 5 years of experience as a Lead Claiming Analyst for external applicants or 3 years of experience as Claiming Assistant for internal applicants can be substituted for education requirement. Maintains all required licenses and certifications.   Additional Requirements: Basic math skills. Ability to accurately enter detailed accounting data on the computer. Intermediate level knowledge of Microsoft Excel and Outlook programs.   All candidates who are presented with a conditional offer of employment must satisfy a pre-employment background check, drug, and health screen.   Sycamores is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state, or local protected class.    Further, Sycamores is a Fair Chance employer and complies with California Government Code Section 12952, Employment Discrimination: Conviction History.

Salary : $68,640 - $72,000