Medical Billing and Reimbursement Specialist

Job Description

Job Description

Description:

Fulfill your purpose at CLM:

Center for Life Management (CLM) provides the area's most comprehensive array of outpatient mental healthcare. We offer innovative and evidence-based services that enhance the health and well-being of individuals and families. We partner with local and state-wide organizations to achieve our mission and together build stronger communities and greater awareness for whole health and wellness. Working as part of the Finance Department Team, the Medical Billing and Reimbursement Specialist will assist with the billing, collection and reconciliation of the agency’s receivables. This is a full time, 40 hour per week position and is considered non-exempt in accordance with the Fair Labor Standards Act (FLSA). The hours will be Monday – Friday 8am-4:30pm onsite at our Derry, NH location.

Major Functional Areas and Description of Duties

• Perform billing to third party and clients for services provided;
• Process and reconcile payments;
• Monitor and post insurance denials; correct billing errors or process appeals, as needed;
• Respond to client/guarantor inquiries regarding outstanding balances; establish payment plans or setup charitable care, as needed;
• Manage the client payment portal to include insurance code mapping, documentation of system processes, procedures and protocols;
• Work the monthly aging receivables to ensure collection of outstanding balances;
• Monitor the unbilled service report and correct billing errors to allow for accurate billing;
• Monitor and comply with changes in state and insurance carrier regulations and requirements to ensure accuracy of billing procedures;
• Promotes a positive work environment and culture that fosters cooperation, teamwork, professional growth and development;
• Engages in appropriate meetings and committees, both internally and externally, as determined by supervisor;
• Executes all required functions in accordance with agency policies, federal and state standards;
• Functions professionally and represent CLM in a professional and appropriate manner in all settings;
• Performs all other duties as assigned by supervisor.

Qualifications, Skills and Experience

• High school diploma or equivalent required; an Associates’ Degree is preferred;
• Minimum of two years of third-party billing experience is required;
• Strong communication, interpersonal, and customer service skills required to interact with internal and external customers in a professional manner;
• Strong organizational skills, ability to problem solve, multi-task, and manage competing tasks while attending to details and adhering to deadlines;
• Ability to maintain composure and exercise sound judgment in routine, urgent, and emergent administrative tasks;
• Proficient computer skills and knowledge of Microsoft office applications with emphasis on Word, Excel, Outlook and TEAMS;
• Ability and desire to work as part of a team while also able to be self-directed and motivated with minimal supervision;
• Flexibility to adapt schedule and fill in as needed;
• Ability to acquire and effectively execute new skills as needed according to evolving department needs.

Physical Demands and Working Conditions

The work will be onsite in an office setting. Manual dexterity is needed to use computers and standard office equipment. The ability to sit for extended periods of time is required.

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• High school diploma or equivalent required; an Associates’ Degree is preferred;
• Minimum of two years of third-party billing experience is required;
• Strong communication, interpersonal, and customer service skills required to interact with internal and external customers in a professional manner;
• Strong organizational skills, ability to problem solve, multi-task, and manage competing tasks while attending to details and adhering to deadlines;
• Ability to maintain composure and exercise sound judgment in routine, urgent, and emergent administrative tasks;
• Proficient computer skills and knowledge of Microsoft office applications with emphasis on Word, Excel, Outlook and TEAMS;
• Ability and desire to work as part of a team while also able to be self-directed and motivated with minimal supervision;
• Flexibility to adapt schedule and fill in as needed;
• Ability to acquire and effectively execute new skills as needed according to evolving department needs.

Physical Demands and Working Conditions The work will be onsite in an office setting. Manual dexterity is needed to use computers and standard office equipment. The ability to sit for extended periods of time is required.