Billing Specialist

Rcm Billing Specialist

RethinkFirst was founded in 2007 with a mission to provide scalable, evidence-based autism treatment training tools and caregiver supports to an underserved population. Over time, we expanded our offerings to support the entire behavioral health community by adding solutions in the employer, provider, and payor industries, and to drive whole child wellness and success in education. Today, we're proud to have almost 500 team members working to support over 2,000 customers worldwide as we work together to support our communities and help every individual reach their potential. We continue to focus on the future of transforming behavioral health through data science, analytics, and enabling value-based care. With patent-pending solutions and the largest published ASD dataset, RethinkFirst can focus on improving outcomes and having a positive impact on the millions of lives it supports.

Our Billing Services Division specializes in Revenue Cycle Management, Enrollment and Credentialing, and Benefit Authorization Management services. We are growing and are looking for new team members that will offer our clients best-in-class billing services. We support mission-oriented companies that impact the lives of thousands of individuals with autism and their families. We are excited to offer the opportunity for professional and collaborative individuals to grow and be part of something exciting.

The RCM Billing Specialist is responsible for supporting our billing teams by working with insurance companies to ensure efficient and prompt reimbursement for therapy sessions for our customers through timely and clean claim submission.

Job Duties:

• Ensure strict HIPAA-compliant confidentiality with all client data and claims
• Manage and operate in multiple different billing platforms dependent on client needs which could include Azalea, Tebra, Central Reach and/or Rethink Integrated Billing Module
• Manage assigned client accounts billing scrubs for primary and secondary claims
• Submit claims electronically for primary and secondary payors
• Solve clearinghouse rejections
• Submit corrected claims for billing errors, rebill projects (new plans/new year, new information on payor policies)
• Maintain account spreadsheets, billing cheat sheets, provider, and billing information including provider roster and payer policy billing rules
• Contribute to updates and communicate to Customer Billing Advocate and other members of POD
• Provide internal reporting to team of status and issues for clients within POD
• Meet internal benchmarks for clean claims / first pass rate, unbilled claims, clearinghouse rejections, secondary claims, and denials for billing errors
• Research specific payor billing rules as needed
• Review client billing documentation to ensure claims are submitted based on payor requirements
• Stay informed about Payor and Industry Billing rules
• Foster a positive work environment for team members

Requirements:

• 1-2 years of billing experience in speech, occupational, and ABA therapy.
• Strong knowledge of CPT coding and billing rules for major health insurance companies
• Experience working directly with large insurance companies such as Blue Cross Blue Shield, Cigna, Magellan, etc.
• Proficiently using Billing Software and Clearinghouse systems (Azalea, Kareo, Waystar, TriZetto, Azalea, Central Reach).
• Proficient using Microsoft Suite (Outlook, Excel, Word).

Preferred Qualifications:

• Previous ABA, Speech, OT, and Mental Health billing experience.
• Minimum 1-2 years' experience working in an office setting
• Minimum 1 year experience in billing both major commercial insurance companies as well as state Medicaid programs
• Experience using insurance company websites/portals
• Proficient using Microsoft Suite (Outlook, Excel, Word)

Education:

• Bachelor's degree preferred/ HS Diploma or Equivalent required

Benefits:

• PTO and Vacation Days after a 90-day introductory period
• Paid Holidays
• Generous Health, Denial & Vision benefits package
• 401k + Matching

Job Type: Full-time, Hourly, Monday-Friday (9-6 PM) Remote opportunities are available only in the following states: AL, AR, AZ, CA, CO, FL, GA, ID, IL, IN, IA, MO, NC, NE, NY, OH, PA, SC, TN, TX, UT, VA

Our commitment to an inclusive workplace

RethinkFirst is an equal opportunity employer and is committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because that is what drives curiosity, innovation, and the success of our business. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.