Mental Health Billing Specialist Accounts Receivable
Teras Interventions and Counseling, Inc., Portland, OR, United States
BILLING SPECIALIST/ACCOUNTS RECEIVABLE FOR BEHAVIORAL HEALTH
PAY:
Hourly/Negotiable and bonuses for out of network commercial insurance reimbursements
EMPLOYMENT STATUS:
Part time employee W2 or 1099 contractor
WORK FROM OUR OFFICE During probation period and then from HOME : We are an Oregon Health Authority certified outpatient substance use disorder treatment agency serving Multnomah County and surrounding areas contracted to serve individuals with Oregon Health Plan CareOregon, Trillium and DMAP and Out of Network for a variety of private insured plans. In network for CIGNA and MODA. We are seeking an individual (not an agency) living in the Portland, Oregon area who has extensive experience in Behavioral health insurance billing and credentialing; specifically, for mental health and substance use disorder treatment services provided by non-licensed professionals (CADC’s) through an OHA certified facility. Also, familiarity with government contract administration- ex: Intoxicated Driver Program Fund, Multnomah County Health.
PLEASE READ: If most of your experience is with medical only or with mental health for licensed professionals-Thank you for taking the time to read this far but we will not be able to consider your resume for consideration at this time.
LOCATION : Onsite at facility located in the SE Hawthorne area of Portland. After an established working relationship including a full audit of the last year’s billing and minimum of 60 days probationary period there will be the option to work remotely.
Billing Specialist Duties
Verify insurance eligibility for benefits, deductibles, out of pocket balances, pre-authorizations, primary and secondary coverage and update in client record in Reliatrax.
Review and submit claims from EHR through Office Ally or another clearinghouse.
Prepare report of various payer EFT payments for bookkeeper to reconcile in QuickBooks if needed.
Retrieve EOBs online, from provider and post payments to the appropriate patient accounts, applying write offs or adjustments.
Assign appropriate ICD‑10, HCPCS modifiers and CPT codes to maximize payments for agency with out of network insurance plans.
Assertively research denials and timely resubmit claims according to payment remittance advice and ever‑changing NCC edits.
Perform Medicaid crossovers and submit claims as secondary or tertiary insurances after the primary has paid.
Assist and perform credentialing, re‑credentialing, apply for EFT.
Experienced with setting up and managing a facility CAQH account along with individual accounts.
Computer Program Skills
Microsoft Office (Word, Excel, Outlook), Google Docs, Gmail, Sheets.
Proficiency in use of multi‑carrier websites including OHP/MMIS, PhTech, OneHealthPort, Office Ally, CareOregon HealthTrioConnect, UHC/Optum and Availity, CAQH.
Additional Skills/Duties
Review previously submitted claims over the year for errors and resubmissions.
Consulting on various compliance issues and other duties related to the position.
Respond to agency request for individualized reporting for contract and grant requirements.
Support transitioning from previous billing specialist agency as needed.
#J-18808-Ljbffr
PAY:
Hourly/Negotiable and bonuses for out of network commercial insurance reimbursements
EMPLOYMENT STATUS:
Part time employee W2 or 1099 contractor
WORK FROM OUR OFFICE During probation period and then from HOME : We are an Oregon Health Authority certified outpatient substance use disorder treatment agency serving Multnomah County and surrounding areas contracted to serve individuals with Oregon Health Plan CareOregon, Trillium and DMAP and Out of Network for a variety of private insured plans. In network for CIGNA and MODA. We are seeking an individual (not an agency) living in the Portland, Oregon area who has extensive experience in Behavioral health insurance billing and credentialing; specifically, for mental health and substance use disorder treatment services provided by non-licensed professionals (CADC’s) through an OHA certified facility. Also, familiarity with government contract administration- ex: Intoxicated Driver Program Fund, Multnomah County Health.
PLEASE READ: If most of your experience is with medical only or with mental health for licensed professionals-Thank you for taking the time to read this far but we will not be able to consider your resume for consideration at this time.
LOCATION : Onsite at facility located in the SE Hawthorne area of Portland. After an established working relationship including a full audit of the last year’s billing and minimum of 60 days probationary period there will be the option to work remotely.
Billing Specialist Duties
Verify insurance eligibility for benefits, deductibles, out of pocket balances, pre-authorizations, primary and secondary coverage and update in client record in Reliatrax.
Review and submit claims from EHR through Office Ally or another clearinghouse.
Prepare report of various payer EFT payments for bookkeeper to reconcile in QuickBooks if needed.
Retrieve EOBs online, from provider and post payments to the appropriate patient accounts, applying write offs or adjustments.
Assign appropriate ICD‑10, HCPCS modifiers and CPT codes to maximize payments for agency with out of network insurance plans.
Assertively research denials and timely resubmit claims according to payment remittance advice and ever‑changing NCC edits.
Perform Medicaid crossovers and submit claims as secondary or tertiary insurances after the primary has paid.
Assist and perform credentialing, re‑credentialing, apply for EFT.
Experienced with setting up and managing a facility CAQH account along with individual accounts.
Computer Program Skills
Microsoft Office (Word, Excel, Outlook), Google Docs, Gmail, Sheets.
Proficiency in use of multi‑carrier websites including OHP/MMIS, PhTech, OneHealthPort, Office Ally, CareOregon HealthTrioConnect, UHC/Optum and Availity, CAQH.
Additional Skills/Duties
Review previously submitted claims over the year for errors and resubmissions.
Consulting on various compliance issues and other duties related to the position.
Respond to agency request for individualized reporting for contract and grant requirements.
Support transitioning from previous billing specialist agency as needed.
#J-18808-Ljbffr