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Billing Specialist (Mental and Behavioral Health)

Finance | Washington, DC | Full Time and Part Time

Job Description

ABOUT US

One Common Unity (OCU) breaks cycles of violence and builds compassionate, healthy communities through the transformative power of music, arts, and peace education. Founded in 2000 following a string of school shootings in Washington, DC, OCU is a collaborative effort between educators, artists, and health practitioners dedicated to preventing violence and improving life outcomes for youth and families. Currently based in 23 schools throughout Washington, DC, we train the next generation of youth leaders in social-emotional literacy, arts expression, and conflict transformation and support them to create positive social change and healing in their communities. Over the past 19 years, we have impacted over 32,500 youth and families, trained over 11,500 teachers, hosted over 81 public concerts and performances, and recently were awarded the Mayor’s Arts Award for Excellence in the Humanities.

ABOUT THE POSITION

OCU is seeking an experienced Mental and Behavioral Health Billing Specialist to lead the insurance billing processes for our school- and community- based behavioral health clinical services. The Billing Specialist is responsible for preparing and submitting timely and accurate insurance claims to third party payers and is responsible for appropriate follow up on all accounts pending payment from government and third-party payers. The Billing Specialist supports the implementation of payer regulations, ensuring compliance with regulatory requirements, and verifying payments and adjustments are appropriately applied to accounts based on government, contract, or other regulations or agreements. The Billing Specialist reports to the Director of Finance. This is a part-time, virtual position, with occasional trips to the office. The ideal candidate must be physically located within the Washington, DC area. 


RESPONSIBILITIES INCLUDE:

  • Prepare and electronically submit clean claims to various insurance companies.

  • Research any paid claims not consistent with the original claim, make any corrections and necessary updates and appropriate adjustment documentation.

  • Process any updated information for claims to ensure timely payment. 

  • Research each denied claim and re-bill accordingly.

  • Post payments to the client's accounts and ensure appropriate allocation.

  • Complete monthly billing reports.

  • Retrieve missing intake information.

  • Update client benefit, demographic, and insurance information as needed.

  • Review and post denials to accounts to ensure accurate payment status and account activity.

  • Monitor aging reports and take necessary actions to guarantee payments of claims.

  • Review accounts and make phone calls to assigned insurance groups for insurance follow-up to determine claim adjudication.

  • Identify payments or adjustments that require review by insurance companies. Take necessary actions (i.e., send letters, initiate phone calls, or obtain medical records) to prepare a review to send to the insurance company. Track the account until the correction is made.

  • Assure compliance with applicable billing laws and regulations to maximize cash receipts.

  • Contact insurance carriers regarding non-payments and/or improper payment on claims.

  • Identify problem accounts with payers; investigate and correct errors, follow-up on missing account information, and resolve past-due accounts.

  • Prepare reports to identify and resolve accounts receivable.

  • Prepare, review, and send client statements.

  • Answer inquiries by phone regarding past-due accounts and insurance guidelines; research incorrect addresses for past-due accounts.

  • Assist with negotiating insurance contracts.

  • Responsible for reading and understanding various types of Explanation of Benefits.

  • Keep the supervisor informed of areas of concern and identified problems.

  • Assist with annual financial audit.

  • Maintain strict confidentiality regarding confidential conversations, documents, and files.

  • Participate in educational activities and attend monthly staff meetings.

  • Adhere to all HIPAA guidelines/regulations.

  • Perform other duties as assigned.


QUALIFICATIONS

  • Three (3) years experience in medical insurance billing

  • Advanced knowledge of behavioral health codes

  • Extensive knowledge of official coding conventions and rules

  • Completion of program in medical billing or certification program preferred

  • Thorough knowledge of Mental and Behavioral health coding and billing practices, A/R management and insurance requirements

  • Associates degree or higher level of education preferred 

  • Experience with QuickBooks Desktop accounting software

  • Knowledge of insurance collections or claims follow up required

  • Proficiency with Microsoft Excel and/or Google Sheets

  • A commitment to and understanding of One Common Unity’s mission

  • A strong understanding of guidelines related to HIPAA, OIG, compliance, medical coding, billing behaviors and practices

  • Excellent oral, written, and telephone communication

  • Excellent computer skills, including Excel, Microsoft Word, etc.

  • Able to work independently with minimum supervision

  • Able to thrive in a team-oriented environment and interrelate well with individuals with diverse ethnic and cultural backgrounds and needs

  • Well-organized and highly attentive to detail

Salary Range for this position: $40k - $80k/year ($18-38/hour) based on experience.

Physical Requirement of the Job

The environmental factors and/or physical requirements of this position include the following: While performing the duties of this job, the employee is required to have mobility sufficient to work onsite and move around the work space. Requires good hand-eye coordination, arm, hand and finger dexterity, including ability to grasp, and visual acuity to use a keyboard. The employee frequently is required to be in one position for long periods of screen use, reach with hands and arms, talk and hear both in person and over devices.  The employee interacts in close spaces and frequently with other workers, vendors, and clients.  The position works in an office environment with artificial light and air.

One Common Unity is an equal opportunity, affirmative action employer and encourages applications from people of color, women, differently-abled, LGBTQIA, and other groups that have historically been subject to discrimination.