Claims Analyst

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.