Analyst, Claims

Springstone

What we Treat a full range of mental health and addiction care including: Depression Anxiety PTSD Borderline Personality Disorder Bipolar Disorder Psychosis Suicidal and Homicidal Ideations Drug and Alcohol Addiction.

Our Programs Full continuum of care; 24/7 crisis care and assessment; inpatient mental health treatment inpatient drug and alcohol detox and rehab partial hospitalization programs (PHP); intensive outpatient programs (IOP); virtual assessments virtual outpatient care.

Populations Served Adult child and adolescent military veterans first responders and other high-risk frontline professionals (Help for Heroes program)

Essential Functions:

Job Responsibilities:

• Accurately performs billing and collections for multiple facilities for all payors.
• Provides professional and technical support to staff. Responds to requests from insurance carriers family members and patients regarding account balance issues.
• Act as administrator for payor website/log in access.
• Ensures accurate capturing and posting of financial activity and maintains accounts receivable at amounts appropriate for payor and acuity mix for all facilities
• Actively works with the Utilization departments in all facilities to ensure pre-certifications certifications and appeals are completed accurately and in a timely manner.
• Assigns tasks to staff through billing software as needed.
• Develops implements monitors and evaluates quality assurance activities ensuring compliance with standards laws regulations and procedures.
• Recommends new and /or revised policies and procedures as needed.
• Reviews and approves all adjustments and refunds for all facilities.
• Attends and prepares for weekly AR Calls.
• Assists with A/R Month End close process.
• Participates in hiring supervision and evaluation of assigned staff.
• Accurately perform billing and collections for multiple facilities for all payors

Education & Experience:

Education:

• High School diploma or equivalent Required
• Associates degree Preferred

Experience:

• Working knowledge of Medicare / Medicaid guidelines and institutional (UB04) Billing Requirements at least three to five years of computerized medical billing experience with a minimum of one year experience in behavioral healthcare and three to five years of supervision / management experience in healthcare setting.
• Additional Requirements: May be required to work flexible hours and overtime

EEOC Statement:

Springstone is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color race sex age religion national origin disability genetic information gender identity sexual orientation veterans status or any other basis protected by applicable federal state or local law.

PHYSICAL MENTAL AND SPECIAL DEMANDS
1. Ability to sit and stand (at least two-thirds of the shift) and walk (possibly one-third of the shift).
2. Ability to reach above or below waist height kneel bend stoop turn and twist (occasionally to frequently).
3. Visual ability to read charts treatment plans financial documents computer screen and typewritten materials.
4. Ability to frequently push/pull wheeled carts to 100 pounds.
5. Ability to frequently lift and carry 10 lbs.; occasionally 20 to 50 lbs.
6. Ability to work in an environment where chemicals are frequently used for cleaning where medical and electrical hazards may be present and where dust mist and steam are frequently generated in housekeeping tasks.
7. Ability to work at a rapid pace and perform a variety of repetitive duties.