About this role

POSITION FUNCTION/OVERVIEW:
Enter all patient demographics into the billing software. Entering and submitting Billable claims to insurance companies, cross checking in Medical EMR to ensure authorization is on file prior to submitting claims. Verifying client policy is active via portal during the billing process before submitting claims. Filing corrected claims and fixing all rejected claims. Updating Action list for all UR issues while billing.

PRIMARY DUTIES/RESPONSIBILITIES:
Promote the mission, values, and vision of the organization.
Provide excellent customer service for clients; practices confidentiality and privacy protocols in accordance with HIPAA requirements.
Research plans and provides the Utilization Review team with information about pre-certification, and policy details.
Work with Utilization Review Specialists to achieve the highest levels of care for the client.
Ensure all required insurance standards and regulations are met.
Performs other duties as required.

Qualifications

QUALIFICATIONS REQUIRED:
• High School Diploma or GED equivalent with combination of education and work experience, required; bachelor's degree, preferred.
• Minimum of two (3) years’ experience in Substance Abuse/ Mental Health Medical Billing and Coding
• Knowledge of Third-Party payers, billing requirements for in network and out of network providers
• Knowledgeable in the field of Substance Abuse treatment.
• Relevant computer software and hardware applications proficiency – Word, Excel, PowerPoint, Outlook, Electronic Medical Records, Billing Systems and/or other scheduling applications; KIPU preferred, Collaborate MD

SKILLS:
• Strong communication skills, both written and verbal.
• Ability to work independently, as well as part of a team.
• Manage multiple tasks and set priorities.
• Ability to handle highly sensitive and confidential information.
• Ability to work in a fast-paced, high-energy environment.
• Excellent interpersonal and customer-facing skills.
• Ability to work accurately, with attention to detail.

This list of essential functions is not intended to be exhaustive. Bournewood Hospital, MA reserves the right to revise this job description as needed to comply with actual job requirements.
PHYSICAL REQUIREMENTS: (N=needed P=preferred)
Sitting N Standing N Walking N Lifting N Carrying N Kneeling N Pushing/Pulling N Bending/Stooping N Climbing P Reaching N Crawling/Crouching n/a Repetitive Motions P Transporting n/a Other ( )
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