HospitalforBehavioral Medicine (HBM) specializes inmental health treatment. Our 120-bed facility is equipped with the latest safety features designed to provide patients with a comfortable environment to receive therapeutic care. Situated in Worcester County, HospitalforBehavioral Medicine is the newestmental health facilityof its kind in the state of Massachusetts and is a joint venture between HBM and UMass Memorial Health Care. A short drive from the UMass Memorial Medical Center, HBM is designed to serve members of the community both near and far.

To learn more about Hospital for Behavioral Medicine, please visit:https://www.hospitalforbehavioralmedicine.com/

If you feel that your skills and compassion fit with our vision for person-centered care and want to make a difference in your community, we invite you to apply today!

Hospital for Behavioral Medicineoffers competitive rates and benefits including:

• Paid Time Off
• Medical, Dental and Vision Plans
• Long-Term Disability
• Life Insurance
• 401k Retirement Plan with Company Match

Position Summary

The Billing Specialist & Collector is responsible for the timely billing of facility claims for behavioral health and chemical dependency for Inpatient and Outpatient levels of care to ensure the reimbursement of claims from various insurance companies. Experience with the Medicare DDE system is required. The biller needs to have experience with the entire revenue cycle, processing claims submission thru a 3rd party intermediary for all payors, resolving claim rejections from payor or intermediary, and have knowledge of ICD 10 codes. Interprets 3rd party requirements and appropriately bills for facility services within timely filing requirements. Will be responsible for following CMS guidelines and remaining current on all internal and external billing policies related to Medicare and Medicaid. Will review claims for accuracy and resolve claim edits according to Payor, Medicare and/or Medicaid billing guidelines for timely payment. Based on error reports; make appropriate corrections to optimize the electronic claims submission process; and pursuing prompt follow-up efforts on aged accounts. Will also assist with meeting patients and/or guarantors to verify insurance benefits and eligibility of coverage for all admission. Will be responsible for preparing admission folders, collecting co-pays/deductibles from patients, assisting with establishing effective and timely payment plans. Departmental coordination with our intake and utilization departments to ensure current and accurate data is communicated. Will work through discharge planning efforts to limit risk of non-payment, providing ongoing patient benefit information for next level of care, and coordinating finalization of financial arrangements.

PRIMARY RESPONSIBILITIES

• Run bill selection daily and process bills and upload daily
• Transmit all electronic claims to Medicare daily. Researches and resolves any electronic claim delays within 24 hours of exception report. Make sure secondary claims and rebills are completed timely.
• Correct rejections daily to ensure timely filings are completed
• Understand payor requirements and special requirements
• Verification of appropriate revenue codes, CPT codes and modifiers
• Provide billing, ensuring proper organization and scheduling of billing, and facilitates the meeting of all requested deadlines
• Review claims for Medicare A, Medicare A No Pays/Benefit Exhaust, Medicare B, and Medicare Secondary Payer claims
• Adhere to facility, department, corporate, personnel and standard policies and procedures.
• Works with Coders to ensure accuracy of data on claims
• Supports leadership with daily, weekly, monthly reporting needs as required
• Experience with UB04 claim forms
• Must be able to interview patients for the purpose of financial eligibility determination.
• Must have basic knowledge of public assistance programs and required financial forms.
• Ability to read UB04 forms.
• Able to read and understand an EOB.
• Can take the necessary action for account resolution in accordance with established federal and state regulations.
• Can verify benefits via online portal or over the phone.
• Understand payor contracts and can verify the insurance company has paid correctly.
• Ability to identify next steps required when a claim has been denied/rejected.
• Excellent communication is needed to document accounts accurately.
• Complete a variety of clerical projects as assigned.
• Adhere to facility, department, corporate and standard policies and procedures.
• Attend all mandatory facility in-services and staff development activities as scheduled.
• Adhere to facility standards concerning conduct, dress, attendance and punctuality.
• Support facility-wide quality/performance improvement goals and objectives.
• Maintain confidentiality of employee and patient information.

Note: The essential job functions of this position are not limited to the duties listed above.

Education: High school graduate or equivalent preferred.
Experience: A minimum of one (1) years experience in facility billing experience with knowledge of Medicare DDE and computerized systems strongly preferred, or related field, or any combination of education, training, or experience in a health care business office environment. Experience with insur-ance billing, computer and business software programs (Excel) preferred.
Additional Requirements: Knowledge of Microsoft Office including word, excel, and outlook. Excel-lent communication skills and a professional demeanor is needed. Detail oriented and possessing strong time management skills is necessary in order to manage multiple priorities in a fast-paced envi-ronment. May be required to work occasional overtime and flexible hours.

KNOWLEDGE, SKILLS, AND MENTAL APTITUDE

THIS SECTION DESCRIBES WHAT KNOWLEDGE, SKILLS AND MENTAL APTITUDE AN EMPLOYEE IN THIS POSITION SHOULD CURRENTLY POSSESS. THIS LIST MAY NOT BE COMPLETE FOR ALL KNOWLEDGE, SKILLS AND MENTAL APTITUDE REQUIRED FOR THIS POSITION.

• Knowledge of insurance rules and regulations.
• Knowledge of general ledger accounts.
• Knowledge of all code procedures.
• Skill in organizing and prioritizing workloads to meet deadlines.
• Skill in telephone etiquette and paging procedures.
• Effective oral and written communication skills.
• Ability to communicate effectively with patients and co-workers.
• Ability to adhere to safety policies and procedures.
• Ability to use good judgment and to maintain confidentiality of information.
• Ability to work as a team player.
• Ability to demonstrate tact, resourcefulness, patience and dedication.
• Ability to accept direction and adhere to policies and procedures.
• Ability to recognize the importance of adapting to the various patient age groups (adolescent, adult and geriatric).
• Ability to work in a fast-paced environment.
• Ability to meet deadlines.
• Ability to react calmly and effectively in emergency situations.

Equal Opportunity Employer

At Hospital for Behavioral Medicine we value a diverse, inclusive workforce and we provide equal employment opportunity for all applicants and employees.We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.