Reimbursement Analyst - $52,163 - $67,813

Join our Team

Join our Finance team, performs accounting and reimbursement duties to maintain the financial records and collection activities of the agency. Responsible for monitoring client Medicaid eligibility and insurance billing information. Staff must possess computer, typing, grammar, punctuation, proofreading, transcription, phone proficiencies and excellent communication and customer relations skills to effectively interact with staff, customers, business partners and community stakeholders. Additionally, the employee must exercise independent decision-making and work effectively in a team-based environment. The employee will complete other tasks as needed in other identified programs/departments as identified in this job description and/or assigned by supervisor. Your office is surrounded by nature, located in Benzie and Manistee Counties, just miles from beaches and hiking trails. Benzie and Manistee are a short drive to Frankfort, Traverse City, Cadillac, and Ludington, charming towns outfitted with shopping, unique restaurants and breweries.


Staff at CWN are valued and receive several great benefits including but not limited to:

• Generous Paid Time Off starting at 160 hours (frontloaded and prorated your first year)
• 12 paid holidays
• Premium Medical, Dental and Vision Insurance
• Health savings account with annual agency contribution
• Awesome coworkers!

Who We Are

CWN is the publicly funded Community Mental Health Service Provider for Manistee and Benzie Counties. We're an established company since the early 1980s (some might even call us vintage!) CWN is about making our communities the best they can be, one person at a time! We seek to provide excellent support to those who need it the most by helping them find their place in our community and live life to the fullest! By holding each other up, we hold our communities up together. It's a serious business, but we leave room for fun, team building and staff support. We're frequently asking, what's the impact on clients and what's the impact on staff?

Who You Are

Your superpower is stellar communication and a collaborative team approach. You are known for your:

• Customer Service Skills : You treat clients and your co-workers with dignity and respect. You are professional in appearance and work habits. You set and work within your boundaries.
• Teamwork : You work collectively to enhance team performance. You promote discussions to share knowledge and experience and assist co-workers in contributing to the overall success of the team and agency.
• Communication : You successfully communicate expressively and receptively, including active listening, frequently interpretating and translating facts and information, explaining situations to people and advising them of alternative or appropriate courses of action.
• Productivity and Quality : You provide quality services to clients and their families and meet or surpass expectations set by your supervisor.
• Problem Solving and Decision-Making Skills : You independently identify and solve problems by applying sound problem-solving skills. Your decisions reflect the best interest of the organization and you accept responsibility for the decisions you make.
• Integrity : You demonstrate honest behavior in all of your roles, tasks and responsibilities, and you follow through on your commitments.
• Reliability : You are personally responsible and complete your work in a timely, consistent manner. You are regularly present and punctual, and you work the hours necessary to complete your assigned work.

About the Role

Performs accounting and reimbursement duties to maintain the financial records and collection activities of the agency. Responsible for monitoring client Medicaid eligibility and insurance billing information.

Your role is to:

• Uses computers to input information into accounting and resource files of the agency.
• Analyzes financial information following MDHHS guidelines to determine client ability to pay amounts.
• Manage billing information in electronic health record.
• Review client financial information verify eligibility and priority payers.
• Responsible for all insurance and private pay billing, including electronic 837 submissions, paper claims, and electronic submissions for fee for service Medicaid billing.
• Review third party billing for proper coding requirements.
• Follow-up and manage all claim rejections and manage appeal process when appropriate.
• Prepare and analyze accounts receivable aging reports, follow up with aged receivables to maintain acceptable collection cycle.
• Manage the Health Home billing process, ensuring all required authorizations are secured and entered the system.
• Provide collection reports including collected and anticipated revenues.
• Records payments, contract adjustments and write offs through manual entry or thought the 835 electronic uploads.
• Responsible for knowledge of insurance agency regulations. Keeps informed of all billing rules and regulations for Medicare, Medicaid, and third-party agencies.
• Responsible for Encounters Per Consumer Data Report 837 to NMRE. Download response file and load into EHR.
• Manage Electronic Verification (EVV) implementation and monitor ongoing process.
• Identify and assist in resolving client eligibility issues.
• Design, prepare and maintain spreadsheets, data tables and reports.
• Manage accounts receivable billing for all administrative contracts.
• Enter cash receipts in general ledger and reconcile cash to client payments for journal entry posting.
• Manage cash transfer to cover cash demands. Approve ACH withdraws.
• Prepare quarterly internal Accounts Payable audits to confirm accuracy and compliance of internal controls.
• Responsible for collecting timesheets, checking for accuracy and processing payroll.
• Monitor Casper Help and train staff when appropriate.
• Cross train and provide back up for Accountant II as needed.
• Perform duties in accordance with well-defined policies, procedures and instruction.

We strive to continually improve the access to and the quality of care for our clients, so your supervisor may assign you to complete other tasks.


At CWN, we recognize all people's vulnerabilities to trauma and traumatic experiences and how that impacts daily living. We use practice models suitable for our job that are evidence based or best practice to support our staff's daily functions, models of treatment, strength-based initiatives and quality outcomes. We encourage those with lived experience with mental illness, developmental disability, and/or substance use disorders to apply to bring valuable insight and perspective to our agency.

Requirements

Qualifications and Requirements

• Bachelor's degree in accounting or finance is required or an equivalent combination of education and minimum two years' experience while actively pursuing a bachelor's degree, resulting in the necessary knowledge, skills, and abilities to perform the essential functions of the job is required
• Familiarity of health care billing and all aspects of accounting required

Benefits:

• Premium healthcare insurance including medical, dental, and vision for individuals, and families
• Health Savings Account with annual employer contribution
• Flex Spending Account
• Retirement Plan with employer matching
• 160 hours of paid time off (prorated your first year)
• Twelve (12) paid holidays
• Ongoing training and education
• Tuition reimbursement
• Employee Assistance Program
• Short Term Disability
• Long Term Disability
• Life Insurance

Work Environment:

CWN prioritizes a work/life balance. Your supervisor will work with you to utilize flex time and paid time off. You will primarily work in the office with the following schedule:

• Monday through Friday
• Between 8:00am and 5:00pm

You may be required to work hours outside of the regular schedule if assigned by your supervisor to meet clients' needs.