Job: Insurance / Billing Specialist

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Jobing Description

IMPORTANT: RESUMES THAT DO NOT INCLUDE A PHONE NUMBER WILL NOT BE CONSIDERED.

Submit billing for assigned JCMH contracts and post receipts in a timely manner. Do deposits, insurance verifications, client statements and month end reporting. Provide customer service to clients, therapists and outside providers.

* Distribute interoffice and outside mail for Insurance Department.

* Do corporate deposits twice a week. Backup for team deposits when needed. Key daily lockbox payments for client payments. Do deposit for Flex Spending Account. Do deposit for Foothills Legacy Breakfast.

* Insurance verification from T-mail on Tier within 2 hours. Do Payor Unpending Report twice a day (Run Contract and Insurance Payors). Help out other staff members on verification per schedule.

* Unpend client accounts daily with financial sheets and set up authorizations.

* Claim review and submission monthly. Payors: CHP+, Mountain Medical, Mines and Assoc., Sloans Lake, Victim‚s Comp., Schools., Access Advantage, Humana, Aetna, and Great West.

* Insurance Payment Posting. Post remits and adjustments monthly. Follow up with denials and rebill monthly.

* Insurance Authorizations. Review authorizations from Insurance company and enter into the MCO system weekly. Send a copy to assigned therapist.

* Monthly Reports. 90 Day Aging. MCO report. Closed Client. Clients going to Collections. Monthly Run Karen House, Injectable, and Medicaid Substance Abuse Report for Payments.

* Customer Service. Research client inquiries and resolve in a timely manner.
Help those in the outside offices with questions. Abide by JCMH customer service policies.

* Post and Blue Spruce Pharmacy-Medicaid and Third Party Remits.

Skills / Requirements

Knowledge of Insurance and managed care companies, Medicare and Medicaid. Experience with the overall billing process: claim forms, authorizations, payment posting, cpt coding, benefit verifications and eob adjustments. Good computer and customer service skills are required. Excel is a must. Experience with aging reports and general ledger reconciliations. Experience with pharmacy billing. Bilingual preferred but not required.