Reimbursement Specialist Medical Billing/Insurance Verification 901

Profile

u003cpu003eFounded in 1965, Telecare is a rapidly growing mental health care company dedicated to making a difference for our clients, the community, and our employees. We offer an array of mental health services to adults with serious mental illness. We partner with public sector entities and behavioral health organizations, and have over 135 programs and over 3,900 employees across the country. And weu0027re growing all the time! When you work at Telecare, you help to empower thousands of individuals every day in their journeys of recovery.u003c/pu003enu003cpu003eOur Corporate Headquarters has over 250 employees in following departments:u0026nbsp; Executive, Development, Finance, Information Systems, Human Resources, Operations, and Marketing u0026amp; Operations.u003c/pu003enu003cpu003eu003cstrongu003eEmployment Status: u003c/strongu003eu0026nbsp;Full Timeu003c/pu003enu003cpu003eu003cstrongu003eShift:u003c/strongu003eu0026nbsp; 8am - 4:30pmu003c/pu003enu003cpu003eu003cstrongu003eDays:u003c/strongu003eu0026nbsp; Monday - Fridayu003c/pu003enu003cpu003eu003cstrongu003ePOSITION SUMMARYu003c/strongu003eu003c/pu003enu003cpu003eThe Reimbursement Specialist is responsible for all billing and collection activities for assigned fee for service/third party facilities, including Medicare and Medi-Cal/Medicaid, counties, commercial insurance and clients. Keeps up to date on all applicable CPT and other coding changes, fee for service and/or contract billing rates and communicates those changes to all affected parties at Telecare. There may be some travel to locations where Telecare does business or plans to do business.u003c/pu003enu003cpu003eu003cstrongu003eQUALIFICATIONSu003c/strongu003eu003c/pu003enu003cpu003eRequired:u003c/pu003enu003culu003enu003cliu003eThis position requires five (5) years of prior medical billing experience or 2 years of college and one year of healthcare experience.u003c/liu003enu003cliu003eExtensive knowledge of Medicare, Medi-Cal/Medicaid and commercial insurances are requiredu003c/liu003enu003cliu003eOne (1) year of insurance verification experienceu003c/liu003enu003cliu003eA high level of PC literacy, especially in Excel and Word, is also requiredu003c/liu003enu003cliu003eThe ability to operate independently, utilizing past extensive reimbursement experience and judgment, is essentialu003c/liu003enu003cliu003eThis position requires the demonstrated capacity to work with sophisticated automated billing systemsu003c/liu003enu003cliu003eOther necessary skills include analytical and problem solving skills, the ability to understand complex reimbursement structures and governmental regulations and the ability to work and communicate effectively with program staff, management staff, government representatives and customersu003c/liu003enu003cliu003eApplicant must be fingerprinted and receive clearance from the Department of Justice and The Office of inspector Generalu003c/liu003enu003cliu003eAll opportunities at Telecare are contingent upon successful completion and receipt of acceptable results of the applicable post-offer physical examination, 2-step PPD test for tuberculosis, acceptable criminal background clearances, excluded party sanctions, and degree or license verification. If the position requires driving, valid driver license, a motor vehicle clearance and proof of auto insurance is required at time of employment and must be maintained throughout employment. Additional regulatory, contractual or local requirements may applyu003c/liu003enu003c/ulu003enu003cpu003ePreferred:u003c/pu003enu003culu003enu003cliu003eBacheloru0026rsquo;s or AA degreeu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eESSENTIAL FUNCTIONSu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eDemonstrates the Telecare mission, purpose, values and beliefs in everyday language and contact with the internal and external stakeholdersu003c/liu003enu003cliu003eAssists in developing the overall philosophy and objectives of accounts receivable services in accordance with the corporate missionu003c/liu003enu003cliu003eResponsible for performing all of the billing and collection activities for assigned programs, ensuring timely and accurate billing including:u003c/liu003enu003c/ulu003enu003cpu003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; ou0026nbsp;Confirm census, financial eligibility data, authorizationsu003cbr /u003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp;u0026nbsp;o Complete paper and/or electronic billing to multiple payersu003cbr /u003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp;u0026nbsp;o Post payments, manually and electronicallyu003cbr /u003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp;u0026nbsp;o Identify under/overpayments and process refundsu003cbr /u003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp;u0026nbsp;o Respond to claim denials timelyu003cbr /u003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; o Run aging reports for collection call identification and complete collection calls and follow up note entryu003cbr /u003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp;u0026nbsp;o Identify bad debt and complete write off requestsu003cbr /u003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp;u0026nbsp;o Identify/complete billing adjustmentu003cbr /u003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp;u0026nbsp;o Client statementsu003cbr /u003eu0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp; u0026nbsp;u0026nbsp;o Complete month end reconciliationu003c/pu003enu003culu003enu003cliu003eCollaborates with other management staff in strategic planning or development activities with the goal of ensuring ongoing effective billing and reimbursementu003c/liu003enu003cliu003eActive member of the Financial Review Committee, creating the agenda and leading the discussions about the pending receivables.u003c/liu003enu003cliu003ePromotes and maintains harmonious and effective relationships and communications within the department, with other departments, with government representatives and with customersu003c/liu003enu003cliu003eConsistently updates knowledge of regulations, procedures and standards to assure compliance with contractual obligations and directives from governmental and regulatory agencies, fiscal intermediaries and contracting entitiesu003c/liu003enu003cliu003eManages all third party denials and appeals, making certain that all appeals are completed on an accurate and timely basisu003c/liu003enu003cliu003eProvides technical support and oversight of third party reimbursement functions performed at the program level, especially for new programsu003c/liu003enu003cliu003eWorks with the Billing Manager to implement and maintain written policies and procedures so that the appropriate submission, billing and payment cycle of client accounts are maintainedu003c/liu003enu003cliu003eActively participates in meeting customer needs and adapting to changing customer needs at all timesu003c/liu003enu003cliu003eParticipates as a Revenue Cycle Department member and provides input via reporting observations, concerns and asking appropriate questionsu003c/liu003enu003cliu003eAppropriately applies rules and regulations in preparation of billingsu003c/liu003enu003cliu003eFollows proper internal controlsu003c/liu003enu003c/ulu003enu003cpu003eDuties and responsibilities may be added, deleted and/or changed at the discretion of management.u003c/pu003enu003cpu003eu003cstrongu003eEOE AA M/F/V/Disabilityu003c/strongu003eu003c/pu003enu003cpu003eamartinez123u003c/pu003e,EqualOpportunityEmployerDescription:Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities,PayTransparencyPolicyStatement:The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c),MatchScore:1.0,HasApplied:false,ApplicationJobBoardName:null,ApplicationJobBoardId:null,DateApplied:null,Salaried:true,CompensationAmount:null,PublishingStatus:1,Links:[],BehaviorCriteria:[],MotivationCriteria:[],EducationCriteria:[],LicenseAndCertificationCriteria:[],SkillCriteria:[],WorkExperienceCriteria:[],JobBoardMemberships:[{JobBoardId:4f54269c-3a81-e250-e075-3a1a05307eef,PublishedInternal:true,PublishedExternal:false,ExternalPostedDate:null,InternalPostedDate:2021-08-02T18:36:11.282Z},{JobBoardId:2fcbb6f4-e717-17cb-9327-3dd87a55b08d,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2021-08-02T18:36:11.282Z,InternalPostedDate:null}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null,Assessments:[],ApplicationId:null,CompensationAnnualMinimum:null,CompensationAnnualMaximum:null,CompensationHourlyMinimum:null,CompensationHourlyMaximum:null,CompensationCurrency:null});

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