Options Counseling and Family Services in
Billing Specialist
Options Counseling and Family Services in, Eugene, Oregon, United States, 97403
Disability Accommodation: If you are unable to complete this application due to a disability, contact this employer at recruiting@options.org to ask for an accommodation or an alternative application process.
Options Counseling and Family Services, founded in 1991 in Florence, Oregon, has since expanded to serve fourteen counties in western Oregon. Headquartered in Eugene, we provide quality mental health and family preservation services to diverse communities. Committed to supporting health, safety, and empowerment.
Benefits Options offer these benefits to our full-time employees (full-time is any employee working 30 hours per week): company-paid health/vision and dental, long-term disability, and life insurance. For a full list of all benefits, please view our website: https://options.org/careers/benefits.
Studies have shown that women and people of color are less likely to apply for jobs unless they believe they have every one of the qualifications as described. We are most interested in finding the best candidate and our hiring processes are centered on assessing candidates based on diverse experience. Please let us know if you have questions.
General Description As a Billing Specialist, you will be responsible for the weekly billing of Oregon Health Plan (OHP) Medicaid Open Card or Coordinated Care Organization (CCO) and private insurance claims. Your duties include researching failed claims and denials, entering data into various accounting systems, and verifying eligibility and insurance authorizations. You will regularly perform functions within the Options electronic client records (ECR), external systems and clearinghouses, and other internal accounting systems and software.
Required Qualifications
Minimum of a high school education and one year of billing experience, or a comparable combination of education and experience.
Strong computer skills, including proficiency with Microsoft Excel and Word.
Commitment to Options’ core values of inclusion and respect, collaboration, transparency, outcome-based services, and flexibility.
Preferred Qualifications
Experience with an electronic medical record.
Experience in mental health and/or healthcare billing.
Essential Duties and Responsibilities
Verify eligibility and obtain authorizations for new clients.
Obtain re-authorizations and close authorizations when needed.
Open new clients by verifying and entering payer information and authorization information in the electronic medical record.
Discharge clients in the ECR record and close authorizations when needed.
Work with relevant clinical staff & supervisors and ECR support team members on higher-level ECR issues pertaining to billing/admin set up and logistics.
Troubleshoot and follow-up on various ECR issues pertaining to higher-level failed claims.
Track claims flow – assure that claims are moving in a timely manner through the ECR and troubleshoot any issues.
Maintain and update payer plan fee matrixes as fee schedules are updated – troubleshoot the failed claims that arise from new fee schedules.
Coordinate with ECR support staff to assist in completion of new contract set up in ECR – including (as needed), but not limited to: payer entry, payer plan fee matrix entry, procedure code entry, activity entry/creation, activity mapping, and program creation and linking/linkage.
May assist Quality Improvement (QI) Department on new provider set up and credentialing as it impacts billing.
Build claim batches and submit the OHP and DMAP billings electronically.
Perform accounts receivable processing in the electronic medical record.
Reconcile OHP Coordinated Care (CCO) and private insurance remittances.
Research payment differences.
Correct cash sheets for sliding scale and private pay.
Build claim batches for utilization data and submit monthly invoices with case rates for ICTS clients.
Bill private insurance payers and track deductibles and copays.
Reconcile remittances, research payment differences and make corrections on claims from remittances received.
Follow up collateral (secondary) authorizations and pending authorizations.
Bill private insurance, track deductibles and copays, and send out delinquency notices.
Research and correct failed claims and claim denials in the electronic medical record and PHTech claims system for different payers.
Prepare monthly billing statements or invoices for the Child Welfare, Self-Sufficiency, and System of Care contracts with the Oregon Department of Human Services (ODHS).
May be assigned other duties and projects, as needed.
Working Conditions
Vision sufficient to read billing records and related documentation.
Extended periods at a workstation updating client records, including phone work.
Requires continual mental concentration and attention to details.
Extended periods of focus and attention and computer use are frequently required.
Mobility and dexterity that is sufficient to handle required job-realted functions and move about the office when working on-site.
Strict deadlines must be met, which may result in frequent stress.
Salary Minimum: $16.86 per hour – Maximum: $23.61 per hour.
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Options Counseling and Family Services, founded in 1991 in Florence, Oregon, has since expanded to serve fourteen counties in western Oregon. Headquartered in Eugene, we provide quality mental health and family preservation services to diverse communities. Committed to supporting health, safety, and empowerment.
Benefits Options offer these benefits to our full-time employees (full-time is any employee working 30 hours per week): company-paid health/vision and dental, long-term disability, and life insurance. For a full list of all benefits, please view our website: https://options.org/careers/benefits.
Studies have shown that women and people of color are less likely to apply for jobs unless they believe they have every one of the qualifications as described. We are most interested in finding the best candidate and our hiring processes are centered on assessing candidates based on diverse experience. Please let us know if you have questions.
General Description As a Billing Specialist, you will be responsible for the weekly billing of Oregon Health Plan (OHP) Medicaid Open Card or Coordinated Care Organization (CCO) and private insurance claims. Your duties include researching failed claims and denials, entering data into various accounting systems, and verifying eligibility and insurance authorizations. You will regularly perform functions within the Options electronic client records (ECR), external systems and clearinghouses, and other internal accounting systems and software.
Required Qualifications
Minimum of a high school education and one year of billing experience, or a comparable combination of education and experience.
Strong computer skills, including proficiency with Microsoft Excel and Word.
Commitment to Options’ core values of inclusion and respect, collaboration, transparency, outcome-based services, and flexibility.
Preferred Qualifications
Experience with an electronic medical record.
Experience in mental health and/or healthcare billing.
Essential Duties and Responsibilities
Verify eligibility and obtain authorizations for new clients.
Obtain re-authorizations and close authorizations when needed.
Open new clients by verifying and entering payer information and authorization information in the electronic medical record.
Discharge clients in the ECR record and close authorizations when needed.
Work with relevant clinical staff & supervisors and ECR support team members on higher-level ECR issues pertaining to billing/admin set up and logistics.
Troubleshoot and follow-up on various ECR issues pertaining to higher-level failed claims.
Track claims flow – assure that claims are moving in a timely manner through the ECR and troubleshoot any issues.
Maintain and update payer plan fee matrixes as fee schedules are updated – troubleshoot the failed claims that arise from new fee schedules.
Coordinate with ECR support staff to assist in completion of new contract set up in ECR – including (as needed), but not limited to: payer entry, payer plan fee matrix entry, procedure code entry, activity entry/creation, activity mapping, and program creation and linking/linkage.
May assist Quality Improvement (QI) Department on new provider set up and credentialing as it impacts billing.
Build claim batches and submit the OHP and DMAP billings electronically.
Perform accounts receivable processing in the electronic medical record.
Reconcile OHP Coordinated Care (CCO) and private insurance remittances.
Research payment differences.
Correct cash sheets for sliding scale and private pay.
Build claim batches for utilization data and submit monthly invoices with case rates for ICTS clients.
Bill private insurance payers and track deductibles and copays.
Reconcile remittances, research payment differences and make corrections on claims from remittances received.
Follow up collateral (secondary) authorizations and pending authorizations.
Bill private insurance, track deductibles and copays, and send out delinquency notices.
Research and correct failed claims and claim denials in the electronic medical record and PHTech claims system for different payers.
Prepare monthly billing statements or invoices for the Child Welfare, Self-Sufficiency, and System of Care contracts with the Oregon Department of Human Services (ODHS).
May be assigned other duties and projects, as needed.
Working Conditions
Vision sufficient to read billing records and related documentation.
Extended periods at a workstation updating client records, including phone work.
Requires continual mental concentration and attention to details.
Extended periods of focus and attention and computer use are frequently required.
Mobility and dexterity that is sufficient to handle required job-realted functions and move about the office when working on-site.
Strict deadlines must be met, which may result in frequent stress.
Salary Minimum: $16.86 per hour – Maximum: $23.61 per hour.
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