Title: Behavioral Health - Account Receivables Representative
Purpose: We are seeking a proactive, detail-oriented Account Receivables Representative with strong knowledge in the behavioral health and substance abuse specialty. The successful candidate will play a pivotal role in ensuring timely and accurate adjudication of both in and out-of-network claims in both facility and professional based settings. This multifaceted role involves following up on unpaid insurance claims and denials and ensuring proper reimbursement is distributed and received.
**ONLY CANDIDATES WITH 2+ YEARS OF BEHAVIORAL HEALTH EXPERIENCE WILL BE CONSIDERED.
Reports to: AR Manager
Duties and Responsibilities: Duties will include, but may not be limited to:
· Responsible for accurate and timely insurance claims follow-up and accounts receivable resolution for assigned facilities and accounts
· Accountable for concurrent oversight of multiple facilties, payers and specialities that may operate in different states
· Knowledge of commercial and federal insurances, state Medicaid plans, and other third-party billing processes, and familiarity with regulatory and compliance requirements
· Able to interact with various third party insurance carriers and clearinghouses accurately and timely to identify and resolve systematic issues.
· Review incoming mail and faxed documents and handling any tasks related to these correspondences
· Evaluates payments/denials received and ensures claims are escalated appropriately when underpayments or denials are identified
· Ability to deal with highly sensitive accounts and exercise good judgment in solving complex situations
· Be a key contributor to identifying and reporting inefficiencies and opportunities that enhance revenue flow, decrease denials and minimize write-offs
· Maintains strong knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
· Demonstrate excellent customer service, communication skills, creativity, patience, and flexibility in a fast paced environment
· Provide feedback to management based on research and calls to payers to establish payer behavioral trends.
· Cooperate and communicate effectively with peers, and facilities. Follow appropriate communication channels through organizational structure.
· Observe confidentiality of patient information and HIPAA regulations.
· Adapt to changes in a positive manner, giving constructive feedback. Work as an effective team member, collaborating with other disciplines in the provision of care.
· Participate in professional, continuing education related to their field and keep a record of continuing education attendance.
Minimum Requirements:
· Knowledge:
o Working knowledge of insurance companies and policies.
· Skills:
o Computer literacy with spreadsheets, word-processing, business systems. (Microsoft Word, Excel, Outlook)
o Ability to effectively communicate with staff and clients.
o Knowledge of at least one of the following EMR’s: Kipu, Best Notes, Alleva
o Preferred Skills: Knowledge of CollaborateMD, PowerBi
o Required Skills: MUST HAVE 2+ YEARS OF BEHAVIORAL HEALTH / SUBSTANCE ABUSE (FACILITY AND PROFESSIONAL BASED) AR EXPERIENCE, NO EXCEPTIONS
Job Type: Full-time
Pay: $20.00 - $24.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience level:
Schedule:
- 8 hour shift
- Monday to Friday
Application Question(s):
- Please elaborate on your experience as an account receivables representative working in behavioral health/substance abuse space.
Experience:
- behavioral health accounts receivable: 2 years (Required)
Work Location: Remote