Medical Billing Specialist

Wabanaki Public Health & Wellness (WPHW) is growing, and we are excited to be adding new people to our team!  If you value inclusivity, balance, and cultural centeredness and have a true passion for serving others, you may be a great fit for our team!  WPHW is a non-profit organization that serves four federally recognized tribes located in five communities:  the Houlton Band of Maliseet Indians, the Aroostook Band of Mi'kmaq, the Passamaquoddy Tribe at Indian Township, the Passamaquoddy Tribe at Pleasant Point, and the Penobscot Nation.  Wabanaki traditions, language, and culture guide our approach and describe the ways we live in harmony with each other and the land we collectively share.  Services are available to community members living on and off-reservation across the state of Maine.

Position Summary:

We are seeking an experienced and detail-oriented Medical Billing Specialist to join our healthcare team. The ideal candidate will be responsible for accurately assigning/verifying all medical codes to diagnoses and procedures for billing and insurance purposes for all WPHW Center for Healing and Recovery direct care services.  Currently, WPHW has facilities located in Bangor, ME and Millinocket, Maine offering Withdrawal Management (Detox, Medication Assisted Treatment), Intensive Outpatient Program (IOP), and Outpatient Counseling.

This position requires a strong understanding of medical terminology, basic coding guidelines, and insurance regulations in the context of substance use and mental health treatment. Familiarity or experience working with Kipu EMR and Collaborate MD is a plus. If you are a dedicated and skilled Medical Billing Specialist looking to contribute to a dynamic healthcare team in the field of substance use and mental health treatment, we encourage you to apply.

Duties and Responsibilities:

• Review and verify patient information, insurance eligibility, medical documentation, and billing utilizing Kipu EMR
• Ensure appropriate medical codes to diagnoses and procedures in compliance with coding guidelines and regulations for all Healing & Recovery services
• Prepare and submit claims to insurance companies and follow up on unpaid or rejected claims for appropriate insurance payors
• Accurately posts insurance payments, submitting deposit information to supervisors
• Accurately and thoroughly document each collection activity performed
• Work with manager and other team members to resolve all open issues related to revenue cycle
• Generate revenue reports and assist with identifying areas for improvement
• Communicate professionally and effectively with healthcare providers, patients, and insurance companies to resolve billing issues
• Stay updated on changes in coding guidelines, regulations, and insurance policies relevant to substance use treatment and mental health
• Utilize Atrezzo and Health PAS Online for benefits verification, MaineCare prior authorizations, claims corrections and payment reconciliations
• Participates in general or special assignments and other duties as assigned and as deemed necessary
• Participates in team meetings and trainings
• Maintain confidentiality of patient information and adhere to HIPAA regulations (42 C.F.R. Part 2)

• Perform other duties as assigned.

Education and Experience Required:

• High School Diploma or GED equivalent
• Knowledge of medical coding systems (ICD-10, CPT, HCPCS) related to substance abuse treatment, minimum of 1 years of experience medical/substance use/mental health billing and coding preferred
• Certified Professional Coder (CPC) certification preferred
• Experience with Kipu EMR and Collaborate MD, minimum of 1 year; or one year experience with billing and revenue generation for insurers in the State of ME through the use of other EMR software
• Experience working in Tribal Communities preferred. 
  

Skills and Qualifications Required:

• Ability to work independently and prioritize tasks effectively
• Well organized, self-motivated with a positive and professional approach
• Requires working 32-40 hours per week with hybrid scheduling options to meet Center for Healing and Recovery departmental requirements
• Strong attention to detail and accuracy
• Excellent communication and interpersonal skills
• Ability to stay composed in challenging situations
• Ability to work within a flexible schedule
• Experience with computers, other office equipment and MS Office and Teams
• Demonstrated ability to work as part of a team, independently and embrace a culturally diverse setting
• Regular and predictable attendance is an essential function of this position
• Ability to travel and valid State of Maine Driver’s License, insurable under the WPHW’s automobile insurance plan
  
• Must pass criminal background check.

Wabanaki Public Health & Wellness is an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.