Reimbursement Specialist Medical Billing/Insurance Verification - Hybrid Position 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 155 programs and over 4,300 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.u003cstrongu003eu0026nbsp;u003c/strongu003eu003cstrongu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/strongu003eu003c/pu003enu003cpu003eu003cspanu003eOur Corporate Headquarters has over 100 employees in following departments:u0026nbsp; Executive, Development, Finance, Information Systems, Human Resources, Operations, and Marketing u0026amp; Operations.u003c/spanu003eu003c/pu003enu003cpu003eu003cstrongu003eEmployment Status:u0026nbsp;u003c/strongu003eu0026nbsp;Full-Timeu003cstrongu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eShift:u0026nbsp;u003c/strongu003eu0026nbsp;AM 8:30 am - 5:00 pmu003c/pu003enu003cpu003eu003cstrongu003eDays:u0026nbsp;u003c/strongu003eu0026nbsp;Monday - Fridayu003c/pu003enu003cpu003eu003cstrongu003ePOSITION SUMMARYu003c/strongu003eu003cbr /u003eThe 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 members served. 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/pu003enu003cpu003eu003cstrongu003e ESSENTIAL FUNCTIONSu003c/strongu003eu003cbr /u003eu0026bull; Demonstrates the Telecare mission, purpose, values and beliefs in everyday language and contact with internal and external stakeholdersu003cbr /u003eu0026bull; Assists in developing the overall philosophy and objectives of accounts receivable services in accordance with the corporate missionu003cbr /u003eu0026bull; Responsible for performing all of the billing and collection activities for assigned programs, ensuring timely and accurate billing, including:u003cbr /u003eo Confirming census, financial eligibility data, authorizationsu003cbr /u003eo Completing paper and/or electronic billing to multiple payersu003cbr /u003eo Posting payments, manually and electronicallyu003cbr /u003eo Identifying under/overpayments and process refundsu003cbr /u003eo Responding to claim denials in a timely manneru003cbr /u003eo Running aging reports for collection call identification, completing collection calls and making follow up note entriesu003cbr /u003eo Identifying bad debt and completing write off requestsu003cbr /u003eo Identifying/completing billing adjustmentsu003cbr /u003eo Issuing client statementsu003cbr /u003eo Completing month end reconciliationu003cbr /u003eu0026bull; Collaborates with other management staff in strategic planning or development activities with the goal of ensuring ongoing effective billing and reimbursementu003cbr /u003eu0026bull; Serves as active member of the Financial Review Committee, creating the agenda and leading the discussions about the pending receivablesu003cbr /u003eu0026bull; Promotes and maintains harmonious and effective relationships and communications within the department, with other departments, with government representatives and with customersu003cbr /u003eu0026bull; Consistently updates knowledge of regulations, procedures and standards to assure compliance with contractual obligations and directives from governmental and regulatory agencies, fiscal intermediaries and contracting entitiesu003cbr /u003eu0026bull; Manages all third-party denials and appeals, making certain that all appeals are completed on an accurate and timely basisu003cbr /u003eu0026bull; Provides technical support and oversight of third-party reimbursement functions performed at the program level, especially for new programsu003cbr /u003eu0026bull; Works 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 maintainedu003cbr /u003eu0026bull; Actively participates in meeting customer needs and adapting to changing customer needs at all timesu003cbr /u003eu0026bull; Participates as a Revenue Cycle Department member and provides input via reporting observations, concerns and asking appropriate questionsu003cbr /u003eu0026bull; Appropriately applies rules and regulations in preparation of billingsu003cbr /u003eu0026bull; Follows proper internal controlsu003cbr /u003eDuties and responsibilities may be added, deleted and/or changed at the discretion of management.u003cbr /u003eu003cbr /u003eu003cstrongu003eQUALIFICATIONSu003c/strongu003eu003cbr /u003eRequired: u003cbr /u003eu0026bull; Five (5) years of prior medical billing experience or two (2) years of college and one (1) year of healthcare experience.u003cbr /u003eu0026bull; Extensive knowledge of Medicare, Medi-Cal/Medicaid and commercial insurances u003cbr /u003eu0026bull; A high level of PC literacy, especially in Excel and Wordu003cbr /u003eu0026bull; The ability to operate independently, utilizing past extensive reimbursement experience and judgmentu003cbr /u003eu0026bull; This position requires the demonstrated capacity to work with sophisticated automated billing systemsu003cbr /u003eu0026bull; Applicant must be fingerprinted and receive clearance from the Department of Justice and The Office of inspector Generalu003cbr /u003eu0026bull; Must be at least 18 years of ageu003cbr /u003eu0026bull; All 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 driveru0026rsquo;s 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 apply.u003cbr /u003eu003cbr /u003ePreferred:u003cbr /u003eu0026bull; Bacheloru0026rsquo;s or AA degreeu003cbr /u003eu003cbr /u003eu003cstrongu003eSKILLSu003c/strongu003eu003cbr /u003eu0026bull; High level of computer literacyu003cbr /u003eu0026bull; Exceptional attention to detailsu003cbr /u003eu0026bull; Other 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 members servedu003cbr /u003eu003cbr /u003eu003cstrongu003ePHYSICAL DEMANDSu003c/strongu003eu003cbr /u003eThe physical demands here are representative of those that must be met by an employee to successfully perform the essential functions of this job.u003cbr /u003eu003cbr /u003eThe 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, occasionally drives. Visual requirements include computers and books exposure. u003cbr /u003eu003cbr /u003eu003cstrongu003eEOE 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:false,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:2022-04-18T19:21:57.824Z},{JobBoardId:2fcbb6f4-e717-17cb-9327-3dd87a55b08d,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2022-04-18T19:21:57.824Z,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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