Billing & Reimbursement Specialist

WEST MICHIGAN COMMUNITY MENTAL HEALTH SYSTEM; Ludington (MI); On-site; USD 32,000 - 40,000; Full time

Job summary

West Michigan Community Health in Ludington seeks a Reimbursement Specialist to input and verify service activity and generate bills in accordance with payer guidelines. The role ensures accurate data, timely claims, and coordination with MDHHS for Medicaid workflows.

The candidate should have an Associates degree in accounting/finance with billing experience, proficiency in Microsoft Office, and a valid driver's license. This is a full-time position with competitive pay.

Qualifications

• Associates degree in accounting or finance; minimum 1 year of medical billing experience.
• Familiarity with desktop software, including Microsoft applications.
• Experience with accounting procedures and automated billing and office data systems.
• Ability to accurately enter data and use edit reports to balance.
• Must have a valid driver’s license and reliable transportation.
• Lived experiences with mental illness/developmental disabilities/substance use disorders are valued.

Responsibilities

• Data Entry and Data Processing: input service data into required systems for billing and reporting.
• Billing of Services.
• Complete follow-up on rejections.
• Post/payments received from payers and consumers.
• Verify consumer financial and insurance information for accuracy.
• Ensure electronic medical charts are set up to bill insurance policies.
• Understand MDHHS provider qualifications and billing requirements.
• Meet claims submission deadlines; coordinate with MDHHS liaison.
• Complete provider enrollments for billable credentialed staff with insurers.
• Understand CPT and HCPCS codes to identify billable services.

Skills

Data entry

Billing procedures

Microsoft Office

Data interpretation

Office data systems

Driver's license

Education

Associate's degree in accounting or finance

Tools

Automated billing systems

Office data systems

Job description

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

Description

This position is responsible for inputting and/or verifying service activity, including generation of bills through appropriate recording of payment. Responsible for staying current with and following guidelines set forth by Michigan Department of Health and Human Services, Michigan Legislature, Medicaid, Medicare, Blue Cross and other payers.

JOB DUTIES

• Data Entry and Data Processing
  Input of service data into the required clinical and accounting electronic systems so the agency can bill for service, submit required reports and services delivered to the State of Michigan, track staff productivity, etc.
• Billing of Services
• Responsible for completing follow-up on rejections.
• Responsible for posting/applying payments received from payers and consumers for service provided.
• Verification of Data Integrity
  Must be able to verify consumer financial and insurance information accurately.
• Responsible for insuring consumer electronic medical charts are set up correctly to bill the appropriately insurance policies.
• Must understand and become familiar with the Behavioral Health reporting requirements and provider qualifications for providing and billing services on behalf West Michigan Community Health.
• Must meet claims submission deadlines set within internal policies and external contracts.
• Must work with MDHHS Liaison on Medicaid eligibly and other MDHHS/WMCMH shared workflows
• Provider Enrollment
• Must be able to complete provider enrollments for billable credentialed staff to the necessary insurance companies.
• Must be or become knowledgeable with CPT and HCPCS codes and which services are billable for which providers to specific insurances.

Position Requirements

• Associates degree in accounting or finance with a minimum of one year of experience in medical billing, preferably in the mental health field. Candidates with a high school diploma or GED will be considered if they have two or more years of experience in medical billing, preferably in the mental health field.
• Familiarity with desktop software including Microsoft applications essential.
• Candidate will have a demonstrated knowledge of, and proficiency in, accounting procedures and automated billing and office data systems.
• Must have an ability to accurately enter data and utilize edit reports to balance.
• Must be able to effectively and accurately interpret and integrate information presented by system users.
• Must possess a valid driver’s license and provide own transportation to and from meetings and activities at varying work locations including all agency locations in Lake, Mason, and Oceana Counties.
• Lived experiences with mental illness/developmental disabilities/substance use disorders are valued.

Full-Time/Part-Time Full-Time

Pay Range $23.13 - $29.23

Position Reimbursement Specialist

Location Ludington

This position is currently accepting applications.