Lead Reimbursement Specialist

Profile

u003cpu003eu003cspanu003eFounded 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 145 programs and over 4,200 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/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu003cstrongu003eEmployment Status:u003c/strongu003eu0026nbsp;Full Timeu003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu003cstrongu003eShift:u003c/strongu003eu0026nbsp;8am - 4:30pmu003c/spanu003eu003c/pu003enu003cpu003eu003cspanu003eu003cstrongu003eDays:u003c/strongu003eu0026nbsp;Monday - Fridayu003c/spanu003eu003c/pu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003ePOSITION SUMMARYu003c/pu003enu003cpu003eThe Lead Reimbursement Specialist is responsible for all revenue cycle functions for assigned fee for service/third party facilities. Including insurance verification, census, authorization management, billing, collections, cash posting, collections, denials, appeals and write offs/refunds. Additionally, this role serves as the main help contact for the Reimbursement Specialists in their group. Including providing support during contract/payer changes, trains new staff and reviews work of new staff. 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/pu003enu003cpu003eu003cstrongu003eRequired:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eSix (6) years of full cycle revenue cycle experience and extensive knowledge of Medicare, Medi-Cal/Medicaid and commercial insurancesu003c/liu003enu003cliu003eA high level of PC literacy, especially in Excel and Wordu003c/liu003enu003cliu003ePrior experience training staff, using exceptional communication skillsu003c/liu003enu003cliu003eCritical thinking and data validation skills are mandatoryu003c/liu003enu003cliu003eAbility to identify and escalate issues and conflicts to management timelyu003c/liu003enu003cliu003eUnderstanding of accounting principles and the ability to balance detailed accounts to the general ledgeru003c/liu003enu003cliu003eThe ability to operate independently, handle multiple tasks simultaneously and complete assignments with minimal supervision.u003c/liu003enu003cliu003eDemonstrated capacity to work with sophisticated automated billing systemsu003c/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/ulu003enu003cpu003eu003cstrongu003ePreferred:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eBacheloru0026rsquo;s or AA degreeu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eESSENTIAL FUNCTIONSu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eDemonstrate 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/liu003enu003cliu003eServes as main point of contact for Single Case Agreements that need to be negotiated for the programs in assig billing groupu003c/liu003enu003cliu003eResponsible for performing and/or knowing all the billing and collection activities for assigned programs, ensuring timely and accurate billing including:u003c/liu003enu003c/ulu003enu003culu003enu003cliu003eConfirm census, financial eligibility, authorizationsu003c/liu003enu003cliu003eComplete paper and/or electronic billing to multiple payersu003c/liu003enu003cliu003ePost payments, manually and electronicallyu003c/liu003enu003cliu003eIdentify under/overpayments and process refundsu003c/liu003enu003cliu003eRespond to claim denials timelyu003c/liu003enu003cliu003eRun aging reports for collection call identification and complete collection calls and follow up note entryu003c/liu003enu003cliu003eIdentify bad debt and complete write off requestsu003c/liu003enu003cliu003eIdentify/complete billing adjustmentu003c/liu003enu003cliu003eClient statementsu003c/liu003enu003cliu003eComplete month end reconciliationu003c/liu003enu003c/ulu003enu003culu003enu003cliu003eCollaborates with Billing Manager 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 receivablesu003c/liu003enu003cliu003eKeeps Billing Manager informed of status of account receivable for the billing unitu003c/liu003enu003cliu003eMentors new staff in the billing group and performs majority of staff trainingu003c/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/liu003enu003cliu003eReviews month end packets for Reimbursement Staff in billing group u0026ndash; corrects errors with staff as necessaryu003c/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/pu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eSKILLSu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eHigh level of computer literacyu003c/liu003enu003cliu003eExceptional attention to details with a high degree of critical thinkingu003c/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/liu003enu003c/ulu003enu003cpu003eu003cstrongu003ePHYSICAL DEMANDSu003c/strongu003eu003c/pu003enu003cpu003eThe physical demands here are representative of those that must be met by an employee to successfully perform the essential functions of this job.u003c/pu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eThe employee is constantly required to sit and occasionally required to stand, walk, reach, twist, bend, pull and lift and carry items weighing 10 pounds or less as well as to do simple grasping occasionally. The position requires manual deviation, repetition and dexterity. Visual requirements include computers and books exposure.u003c/pu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eEOE AA M/F/V/Disabilityu003c/strongu003eu003c/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:2020-08-14T23:49:28.647Z},{JobBoardId:2fcbb6f4-e717-17cb-9327-3dd87a55b08d,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2020-08-14T23:49:28.647Z,InternalPostedDate:null}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null,Assessments:[],ApplicationId:null});

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