Full time position with full time benefits (Tukwila). The employee in this position supports the Revenue Cycle in the Finance Department by functioning as a specialist in reimbursement for Sound Mental Health. This role encompasses the entirety of the revenue cycle, from account set-up and eligibility verification to claim errors, corrections, A/R resolution, in-depth denial review and detailed review of client ledgers. This employee is responsible for making claim corrections based on review of 837 compile reports, including voids and refunds as appropriate.
- Perform review and resolution of 837 error reports resulting from both the service batching to King County BHO and the Commercial claims batching done by the billing vendor (Netsmart RCM) on behalf of SMH.
- Organize and prepare claim denial data and accounts receivable data to report regularly to the Client Financial Services Manager.
- Research claim denials and make appropriate corrections to claim data that is either initially scrubbed or rejected or denied.
- Communicate regularly with the billing vendor (Netsmart RCM) via email exchange, FTP site uploads and bi-weekly meetings to ensure timely resolution to claim errors and issues.
- Accurately set up new client financial eligibility.
- Accurately enter financial data into the electronic health record.
- Maintain current, accurate and up-to-date client payor information for the duration of the client’s treatment assuring that proper documentation is obtained.
- Assist clinical staff in maintaining accurate client financial records.
- Field customer service questions, both externally (from clients) and internally (from other SMH staff), relating to insurance coverage and benefits.
- Run eligibility verification reports and complete corresponding updates in a timely manner.
- Provide coverage for other team members’ work duties as needed for vacation and sick leave.
- Sort and file all correspondence.
- Participate in staff meetings, individual supervision, and assigned committees, as required.
- Maintain ethical and competent client and peer relationships in the delivery of service.
- Comply with all applicable federal, state, and county laws and regulations and SMH policies and procedures.
- Perform all job duties in accordance with OSHA and company-designated safety regulations.
- Ensure that audit standards are met with regard to client financial records and assist in annual audit.
- Perform other duties as assigned by the Client Financial Services Manager.
KNOWLEDGE, ABILITIES AND SKILLS:
- Revenue cycle experience required.
- Knowledge of 837 compile error reports and claim correction research is required.
- Experience researching complex denial issues and bringing forth resolution.
- Experience working with a third-party billing vendor is preferred.
- Experience with insurance sites – Provider One and other Commercial payors preferred.
- Experience using an electronic health record (EHR) – Netsmart Avatar preferred.
- Thorough knowledge of insurance benefit terminology and medical billing concepts.
- Ability to communicate effectively, verbally and in writing.
- Strong attention to detail and work accuracy.
- Accuracy in keyboard and ten-key.
- Experience with automated accounting systems and Microsoft Office products such as Excel, Outlook, and Word.
- Ability to plan and schedule work assignments with high work volume.
- Ability to work under pressure to meet stringent deadlines.
- Ability to work effectively in a team environment.
- Ability to work effectively with minimal supervision, manage multiple duties and priorities, and maintain high standards for accuracy, productivity and confidentiality.
- Ability to work comfortably with individuals from varying educational, professional, and economic backgrounds, and work compassionately with individuals who have a mental illness.
EDUCATION and/or EXPERIENCE:
- Associate’s degree in business/accounting preferred.
- At least five (5) years of related experience preferred.
- Or equivalent combination of education and experience.
Send letter of interest, resume and salary history to: Sound, Attn:Alexis Owens, 6400 Southcenter Blvd. Tukwila, WA 98188, or fax to (206) 302-2210, or e-mail to Alexis.Owens@Sound.Health