Revenue Cycle Specialist (Biller)

Delphi Technologies; Indiana (PA); On-site; USD 36,000 - 48,000; Full time

Job summary

Community Guidance Center in Indiana, PA is seeking an Insurance Coordinator to generate billing invoices for multiple programs and insurance companies, monitor consumer accounts, and handle claim submissions in line with regulations.

You will contact insurers about rejections and authorizations for mental health and substance abuse services, verify reimbursement rates, track changes to fee schedules, and ensure accurate recordkeeping.

Qualifications

• High School degree or GED with prior work experience
• Knowledge of ICD-10 codes and procedure codes preferred
• Trained in basic accounting procedures and substantial billing knowledge preferred

Responsibilities

• Generate billing invoices for multiple programs and multiple insurance companies.
• Monitor consumer accounts and prepare claim resubmission when needed.
• Contact insurance companies regarding rejections, patient coverage, and authorizations for mental health and drug/alcohol services.
• Monitor reimbursement rates from insurers for accuracy and compare to fee schedules.
• Read updates from insurance companies and track changes in fee schedules or practices.
• Prepare itemized statements for clients or insurers.
• Process authorization requests and enter authorizations into the system.

Skills

Computer skills

Interpersonal skills

Customer service

Office procedures

Time management

Education

High School degree or GED

Job description

Insurance Coordinator (Indiana, PA)

Responsibilities

• Generate billing invoices for multiple programs and multiple insurance companies either in paper format or electronically.
• Monitor all consumer accounts and prepare claim resubmission when needed. Perform billing functions in compliance with state and other billing regulations.
• Contact insurance companies regarding rejections, patient coverage, and authorizations pertaining to mental health and drug and alcohol services. Contact managed care and HMO organizations to establish proper guidelines regarding therapeutic and billing procedures.
• Monitor reimbursement rates from insurance companies for accuracy and compare to the fee schedule and the system.
• Read updates from insurance companies and track changes received. Notify appropriate personnel of yearly changes in fee schedules or other insurance practice changes. Maintain files housing this information.
• Prepare itemized statement for client and/or insurance companies requesting account information.
• Process necessary authorization requests. Scan and attach all received authorizations to the Consumer record in the system.
• Enter all received authorizations into system. Obtain necessary authorizations for all departments as directed. Communicate with managed care companies for authorization when insurance changes occur. Communicate when write-offs/authorizations are in question.
• Adhere to seven recognized Sanctuary commitments which includes social responsibility, social learning, non-violence, open communication, democracy, emotional intelligence, growth and change.

Position Requirements

• Computer skills
• Knowledge of office procedures and equipment
• High School degree or GED as well as prior work experience
• Excellent interpersonal and customer service skills
• Act 33, 34 and FBI Clearances
• Knowledge of ICDM10 codes and procedure codes preferred
• Trained in basic accounting procedures and substantial billing knowledge preferred
• Must be able to use standard office equipment such as a computer, fax machine and telephone
• Solid organizational skills and time-management skills

Full-Time/Part-Time

Full-Time

Travel Required

>10%

Exempt/Non-Exempt

Non-Exempt

Location

Community Guidance Center-Indiana

About the Organization

Come work for an organization where every day is an opportunity to help your community! Our full-time positions all offer full medical, dental, and vision benefits at no cost to the employee for individual coverage. We also have a competitive 403B you can start contributing to right away!
Community Guidance Center is a private, non-profit mental and behavioral health center with offices in Indiana, DuBois, Punxsutawney, Clearfield, Northern Cambria, Greensburg and Clarion, Pennsylvania. We provide a wide range of therapeutic and rehabilitative services and resources to all members of these communities.
Community Guidance Center is a Sanctuary Institute certified organization for trauma-informed care. The Sanctuary Model® is a "...theory-based, trauma-informed, trauma-responsive, evidence-supported, whole culture approach that has a clear and structured methodology for creating or changing an organization culture." As one of the few Sanctuary-certified mental and behavioral health providers in our region, we look forward to continuing to provide a welcoming, caring, safe, positive and enriching environment for our consumers, our family of employees and the communities we serve.

Equal Employment Opportunity Statement

We are an Equal Employment Opportunity Employer. We will consider applicants for this position without regard to any category protected by applicable federal, state, or local law, including but not limited to: race, color, sex, age, disability, religion, citizenship, national origin, ancestry, military status or veteran status, marital status, sexual orientation, domestic violence victim status, predisposing genetic characteristics and genetic information.

This position is currently accepting applications.