Job description

ESSENTIAL POSITION RESPONSIBILITIES Patient Account Management 1. Provide excellent customer service and professional correspondence. 2. Exercise good judgment and tact in dealing with clients. 3. Understand privacy legislation related to healthcare information, (i.e. HIPAA) and follow all HIPAA requirements necessary to maintain patient confidentiality. 4. Ensure accurate charges and adjustments are applied to client accounts (based on a variety of qualified payment plans). 5. Review and send out monthly patient statements. 6. Respond to patient questions regarding their account by telephone, email or by other forms of approved correspondence. 7. Research and resolve client billing/payment problems or issues in conjunction with the Billing Specialist II, Billing Manager (and the Business Manager and Program Managers when necessary). 8. Establish payment plans with residential self-pay clients and any outpatient clients with past due balances (work directly with OP Program Manager when client is still active in services). 9. Post late fees in accordance with agency policy. 10. Monitor client accounts and work with Billing Team to schedule regular reviews of past due accounts. 11. Follow in-house collection guidelines for all past due accounts to include preparing delinquent accounts for further collection action. Front Office and Clinical Team Coordination 1. Perform timely COB (Coordination of Benefits) insurance verification and eligibility, to include researching benefits and eligibility for all private insurance and OHP (Medicaid) clients as needed. 2. Provide training and feedback to front office coordinators and counseling staff related to client accounts and outstanding Accounts Receivable issues. 3. Develop and maintain good working relationships with front office and clinical staff. Billing Cycle Coordination 1. Possess working knowledge of current healthcare reimbursement methodology (i.e. fee schedule, per diem, capitation, etc.). 2. Enter, maintain, and monitor all pertinent data in the EMR billing system (financial, insurance, billing, claims, adjustments, and payment data). 3. Post all insurance and client payments received either manually or using electronic remittance advice. 4. Identify rejected claims data and gather a complete understanding as to why the claims were rejected. 5. Research/investigate rejected claims and cue them to the Billing Specialist II (or the Billing Manager) for resubmission/appeal/resolution. 6. Contact insurance carriers regarding no response claims (including unbilled claims, claims not received by payer, incorrect address, or billing methodology), and work to locate missing payments. 7. Post all insurance and client payments and adjustments into the EMR system (working with other Billing Team members where “special adjustments” are warranted. 8. Record insurance payments paid differently than the contracted amount entered EMR and cue to the Billing Specialist II (or Billing Manger) for resolution. Billing Team Coordination 1. Demonstrate self-direction and strong organizational skills. 2. Work with the Billing Team and the Business Manager to produce and monitor billing reports, review unpaid/denied claims, and identify contract issues that need resolution. 3. Think outside the box and pursue alternative solutions. 4. Demonstrate good communication skills by picking up the phone and following through on open issues. 5. Exhibit strong written, oral, phone, and computer skills. 6. Performs other duties as assigned by the Billing Manager or Business Manager. GENERAL POSITION RESPONSIBILITIES: 1. Health and Safety a. Adhere to safety/health requirements. b. Maintain familiarity with emergency plans/procedures. c. Demonstrate care for equipment, buildings, and all other agency resources. 2. Professionalism and Communication: a. Uphold good attendance/punctuality. b. Use time effectively/efficiently. c. Complete assigned duties on time. d. Follow through on commitments/responsibilities. e. Notify supervisor of issues in a timely manner. f. Provide direct and effective written and verbal communication. g. Address conflict professionally, uses program lines of communication. h. Attend in-service training courses and meetings when requested. 3. Effective Agency Functioning: a. Work collaboratively and respectfully with insurance carriers, community partners, staff, peers, and administration. b. Model cohesiveness by working collaboratively with others, demonstrating to staff that all jobs are essential for healthy work environments and quality care. c. Adhere to policies and procedures, as well as safe work practices. d. Remain flexible with scheduling. e. Perform other related duties as assigned. f. Follow agency policy and procedures. g. Maintain confidentiality. h. Participate in quality improvement efforts. i. Adhere to code of ethics. Organizational Relationship and Evaluation Criteria: The Billing Specialist I will work collaboratively with all Billing Team members to ensure all billing related functions are performed professionally and timely. This position initially reports directly to the Business Manager, however as the Billing Manger position comes online all Billing Specialists will fall directly under the Billing Manager. Performance evaluation will be completed on a yearly basis at minimum. All new hires are subject to a 90-day review period. QUALIFICATIONS Minimum Qualifications/Requirements: High school diploma or equivalent. Minimum 1 year of relevant industry customer service, financial service, accounting, technical or other experience requiring strong attention to detail, ability to problem solve, working under timelines, and producing quality output. Previous medical billing and coding experience and working in the Nonprofit Medical or Behavioral Health setting is preferred. Must maintain a working knowledge of applicable Oregon Administrative Rules. Qualified applicants will be proficient in Microsoft Excel, Word and Outlook and be able to work remotely via Zoom phone, chat, and meeting functions.

Job Type: Full-time

Pay: $20.00 - $22.00 per hour

Benefits:

• 401(k)
• Health insurance
• Paid time off
• Work from home

Schedule:

• Day shift
• Monday to Friday

Ability to commute/relocate:

• Prineville, OR 97754: Reliably commute or planning to relocate before starting work (Required)

Experience:

• ICD-10: 1 year (Preferred)

Work Location: In person

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