Insurance and Billing Specialist

Concord-Counseling-Services; Westerville (OH); On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Competitive Pay

Flexible work environment

PTO + Holidays

Medical, Dental and Vision

Group Life

FSA/HSA

401K plan

Job summary

Concord Counseling Services is seeking an Insurance & Billing Specialist in Westerville, OH to optimize revenue cycle processes through accurate third-party claim submissions and payer communications.

Responsibilities include setting up payer definitions in the EMR, intake insurance setup, staff credentialing with payers, and timely review of claims. The role requires HIPAA compliance and collaboration with clinical and administrative teams.

Qualifications

• Minimum 5 years of experience working with third party payers, ideally in community mental health.
• Minimum 3 years of experience with Excel in a healthcare setting.
• Experience with claim follow-up and payer communications.
• Assists with EMR infrastructure related to claim submission and data entry.
• Understanding Medicare/Medicaid rules and payer guidelines.
• Knowledge of credentialing of staff with payers.

Responsibilities

• Set up payer definitions within the EMR accurately and efficiently.
• Set up client insurance upon intake.
• Credential staff with payers and maintain up-to-date records.
• Review and process claims at various stages of the revenue cycle in a timely manner.
• Serve as liaison for client questions or issues regarding billing and payments.
• Generate itemized patient statements and ensure accuracy.
• Monitor workflow and suggest process improvements to reduce errors.
• Maintain HIPAA compliance and support corporate responsibility programs.

Skills

Third party payer experience

Excel

EMR systems

Credentialing

HIPAA/compliance

Tools

EMR software

Job description

Description

The Insurance & Billing Specialist position serves as a key role in improving the overall effectiveness of revenue cycle collections. The applicant will need to have an extensive background in the submission of claims to third party payers & an understanding of making corrections to maximize cash flow in a healthcare environment, preferably within community mental health. The applicant should also have a background working with electronic medical records (EMR) system software that is utilized to maximize correct third party claim submission. Applicant will become a go-to resource for troubleshooting system issues that end users may have.

The job responsibilities include but are not limited to:

• Responsible for proper and efficient setup of payer definitions within the EMR
• Responsible for proper setup of client insurance upon intake
• Credentialing of new staff with payers
• Responsible for review & process of claims in various stages of revenue cycle in a timely manner.
• Act as a liaison for clients with questions or issues
• Responsible for itemized patient statements
• Monitor work flow and recommend process/procedural improvements as needed.
• Maintain compliance with federal, state and local regulations, HIPAA and the Corporate Responsibility Program

Requirements

• Required: Minimum 5 years of experience working with third party payers (preferably community mental health environment or healthcare setting)
• Required: Minimum 3 years of experience with Excel
• Experience in claim follow-up in a healthcare practice environment preferred.
• Assist with EMR infrastructure as it pertain to claim submission & payment data entry
• Knowledge of Medicare and Medicaid regulations and other insurance guidelines
• Understanding credentialing of direct service staff with third party payers
• An understanding of healthcare billing to minimize the error rate in claim submission

Benefit Highlights:

• Competitive Pay
• Supportive/Flexible work environment with high employee satisfaction rates
• Generous Paid Time off & Holidays
• Medical, Dental and Vision, Group Life, FSA, HSA, and 401K plan

Concord Counseling Services is an Equal Opportunity Employer.