Remote Trizetto Jobs in Indiana (NOW HIRING)

Company Overview
RethinkFirst was founded in 2007 with a mission to provide scalable, evidence-based autism treatment training tools and caregiver supports to an underserved population. In 2010, Rethink launched its first solution, a suite of special needs and behavior management offerings, to support K-12 education. Over time, we expanded our offerings to support the entire behavioral health community by adding solutions in the employer (RethinkCare), provider (RethinkBH), and payor (RethinkFutures) industries, and to drive whole child wellness and success in education (RethinkEd).
Today, we're proud to have almost 500 team members working to support over 2,000 customers worldwide as we work together to support our communities and help every individual reach their potential.
Over the past fifteen years, RethinkFirst's mission has evolved to transform the behavioral health landscape by inspiring and empowering all individuals with behavioral health challenges and those who support them. We continue to focus on the future of transforming behavioral health through data science, analytics, and enabling value-based care. With patent-pending solutions and the largest published ASD dataset, RethinkFirst can focus on improving outcomes and having a positive impact on the millions of lives it supports.
Rethink Billing Overview
Our Billing Services Division specializes in Revenue Cycle Management, Enrollment and Credentialing, and Benefit Authorization Management services. We are growing and are looking for new team members that will offer our clients best-in-class billing services. We support mission-oriented companies that impact the lives of thousands of individuals with autism and their families. We are excited to offer the opportunity for professional and collaborative individuals to grow and be part of something exciting.
Job Summary: The Accounts Receivable (AR) Specialist is responsible for supporting our billing teams by working with insurance companies to ensure efficient and prompt reimbursement for therapy sessions for our customers and actively pursuing all outstanding A/R for customers supported within the RCM division.
Job Duties:

• Ensure strict HIPAA-compliant confidentiality with all client-related data

• Review customer account reports and follow up to ensure any flags/concerns are notated proactively and communicated to the Customer Billing Advocate (CBA)

• Review A/R Aging Reports and follow up with insurance companies regarding expected reimbursement for outstanding claims

• Notate & document all follow up work on aging claims within A/R Aging Reports as required and documented in standard SOPs

• Meet expectations on deadlines for completion of A/R Aging Reports for each customer supported within POD

• Follow up on denials immediately and communicate any trends to CBA

• Follow up on any open A/R tickets in Salesforce as assigned by CBA

• Meet deadlines assigned for A/R work as assigned by CBA

• Utilize denial management platforms for submission of appeals, reconsideration requests, etc.

• Research specific payor billing rules as needed

• Follow up on claims submitted electronically for primary and secondary payors

• Submit corrected claims when needed

• Attend POD meetings and contribute to agenda items as designated by CBA

• Post payments or submit missing payments to posting team and maintain A/R as assigned

• File appeals to insurance and to insurance commissioner as needed

• Stay informed about Payor and Industry Billing rules

• Review & interpret payor contracts when applicable

• Measure and monitor key metrics related to work performance

• Attend customer meetings as needed with CBA

• Work to meet POD goals collectively as cohesive team

• Foster a positive work environment for colleagues

Requirements:

• HS Diploma or Equivalent

• ABA billing experience

• Min. 1-year experience in billing; major commercial insurance companies and state Medicaid programs

• Experience using insurance company websites/portals

• Proficient in using Microsoft Suite (Outlook, Excel, Word)

• Willing to learn, positive attitude and love a good challenge

• Professional writing & phone skills

• This role requires exceptional attention to detail, critical thinking and excellent communication with internal teams and insurance companies

Preferred Qualifications:

• Bachelor's degree

• Speech, OT and Mental Health billing experience

• Minimum 1-year experience working in an office setting

• Minimum 1-year experience in billing company setting

• Experience using Billing Software, EMR and Clearinghouse systems (Rethink, Azalea, Tebra, Central Reach, Waystar, Trizetto, Availity)

• Experience using denial management platform (DocVocate)

Education:

• Bachelor's degree preferred/ HS Diploma or Equivalent required.

Benefits:

• PTO and Vacation Days after a 90-day introductory period

• Paid Holidays

• Generous Health, Denial & Vision benefits package

• 401k + Matching

Job Type: Full-time, Hourly, Monday-Friday (8-5 PM)
Remote opportunities are available only in the following states: AL, AR, AZ, CA, CO, FL, GA, ID, IL, IN, IA, MO, NC, NE, NY, OH, PA, SC, TN, TX, UT, VA
Our commitment to an inclusive workplace
RethinkFirst is an equal opportunity employer and is committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because that is what drives curiosity, innovation, and the success of our business. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.
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