Billing Specialist

We recognize the health disparities of people of color, people from working class backgrounds, women and LGBTQ people. We believe that the experiences of these communities must be valued in the work we do. Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities. For immediate consideration, please submit a resume and cover letter with our application form . Portland Mental Health & Wellness is a thriving private practice and training practice with four locations in Portland, as well as one location in Salem. We are a collaboration of psychologists, psychiatric prescribers, counselors, marriage and family therapists and our trainees. We emphasize relationship first and foremost and diagnosis and treatment from within that relationship. We strongly emphasize trauma informed care, cultural competency, establishing comfort and safety for patients, and coordination of care with primary care doctors, specialists, pediatricians, schools, and other mental health clinicians. Location: Portland, OR (with remote flexibility) Supervisor: Billing Team Supervisor Employee Classification : Non-Exempt (Hourly), Full-Time Hours: Full-Time, 40 hours per week Compensation: $25.85-$28.25/hour Primary Function: The Billing Specialist assists in all medical/mental health billing functions, including, but not limited to acquiring authorizations, verifying patient eligibility, billing to appropriate insurance plans, re-submitting insurance rejections, working claim denials, and tracking insurance and patient payment accounts. The Billing Specialist works independently with support from the Billing Team Supervisor. The Billing Specialist may perform other administrative tasks as requested by the staff. This role offers some flexibility, allowing for the person who fills it to work either in person at one of our office locations or remotely, as long as you are situated within or close to the Portland Metropolitan Area in Oregon or southwest Washington. Essential Functions: Verify patient insurance coverage utilizing phone or online portals. Daily eligibility checks for all OHP plans. Submit prior authorizations to insurance via payer specific online portals or by fax. Follow up on pending/denied authorization requests. Read and interpret insurance explanations of benefits (EOBs). Review charge submission for accuracy (POS, MODs, Telehealth guidelines per payor). Review and resubmit clearing house rejections. Print CMS Forms for certain payers (mainly secondary claims) External claim entry via online portal for specific payers. Resolve insurance claim rejections/denials, and non-payment of claims by payor. Draft effective appeals to insurance companies. Accurate posting of all insurance payments and patient payments in our Electronic Health Record system. Resolve all custom and system driven edits, unbilled and exclusion errors in a timely manner. Research and process insurance refund requests. Generate patient billing statements. Process daily payments for patient accounts. Reviews and monitors patient accounts and collects outstanding patient balances. Maintain open communication with patients regarding balances, insurance benefits and coverage. Establishes payment plans for patients and monitors payment plans on a regular basis. Tracks credit card errors and manages client contact around billing issues. Answers incoming calls to the billing department and resolves patient billing issues. Work as liaison with other departments to facilitate problem solving and data collection appropriate to patient and insurance billing. Complete all tasks, voicemails and emails daily. Maintain working knowledge of state and federal billing guidelines. Follow HIPAA guidelines in handling patient information. Perform other duties as assigned. Minimum Qualifications: Preferred: 2+ years experience in medical/mental health billing. Working knowledge of Insurance Coordination of Benefits. Working knowledge of Medicare and Medicaid and commercial insurance. Working knowledge of Microsoft Excel, Google Workspace (sheets, docs, and slides), and EHR systems. Knowledge of ICD-10 CPT billing codes for mental health. Demonstrate competence and humility in terms of race, ethnicity, gender, sexual orientation, religion, class, ability et al Demonstrate commitment to the preservation of a workplace which embraces diversity Demonstrate commitment to confidentiality of patient and employee information Communicate professionally and effectively with patients and clinicians, always providing stellar customer service Answer phone systems with excellent etiquette – a warm/friendly tone, articulate, and providing understandable responses to questions or concerns Demonstrate a strong understanding of HIPAA policies and regulations Demonstrate a strong attention to detail and organization Demonstrate patience: being patient with people who may have trouble communicating or understanding what is happening is imperative for this position Follow policies and procedures to contribute to the administrative efficiency of the practice, taking initiative to suggest and develop those that may be needed Demonstrate strong computer skills including web based systems Ability to work with Mac OS & Google Workspace Knowledge of the TherapyNotes EHR system and ClickUp are a plus, but not required Equipment Operated: Standard office equipment, including computers, copiers, printers, telephones, etc. Work Environment: When working from a PMHW office, the position is in a well-lit office environment. Varied activities including sitting, standing, walking, reaching, bending, and lifting. Mental and Physical Requirements: Involves sitting approximately 90 percent of the day, walking or standing the remainder. Ability to tolerate mental and emotional distress as an anticipated aspect of the position. May require working under stressful conditions. — Portland Mental Health & Wellness offers a competitive benefits package for full-time employees that includes: Paid Vacation Time (80 hours per year to start) Paid Health Leave (40 hours per year) Paid Floating Holiday Hours (80 hours per year) Medical and Vision Insurance – Kaiser Permanente of the Northwest (choice of three plans) Employer Paid Life and AD&D Insurance Voluntary Additional Life and AD&D Insurance Voluntary Short Term Disability Insurance Voluntary Critical Illness Insurance Voluntary Accident Insurance Flexible Spending Account, Health Care Commuter Benefit – Choice of TriMet Pass or Limited Parking Reimbursement 401K Retirement Plan – Up to 4% Company Match Once Eligible Annual Continuing Education Allowance of $500 Discounted Enrollment with Student Loan Tutor 10% Discount on Vitamins & Supplements Through Fullscript Limited Access to Columbia Sportswear Employee Store OnPoint Community Credit Union Group Banking Benefits — This description is intended to provide only the basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as the practice’s needs evolve. Regular and predictable attendance is an essential function of every job. The requirements described above are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. By signing below, you acknowledge that you are able to perform the Essential Functions of this job, with or without accommodation. If an accommodation is needed, you acknowledge that you have an opportunity to discuss this with Human Resources. Portland Mental Healthis an equal opportunity employer. We support and encourage diversity. #J-18808-Ljbffr Portland Mental Health