Position: Financial Services Specialist for Behavioral Health Centers
Overview: Resolution of all financial issues including payment posting errors, refunds, takebacks, and payment correspondence.
- Resolution of unresolved payment issues including:
- Posting payments, adjustments, and denials or perform necessary corrective actions.
- Remittance and deposit troubleshooting.
- Time of service payment resolution and tracking.
- Commercial and Self Pay Refunds processing for all payers.
- Incorrect or unapplied payment resolution research.
- Collection accounts review and resolution
- Financial reconciliation and tracking issues.
- Understanding of payment lifecycle from initial Tax ID set up to deposit tracking and posting corrections
- Conducts research on insurance websites and retrieves necessary documentation to post payment and denial information.
- Manage payment tracking in Athena including US. Bank Lock Box and payment routing.
- TAP payments – Client specific private pay payment plan. Runs scheduled credit card payments manually in Athena.
- Transfer money between departments – patients are registered in multiple departments depending on the provider’s credentialing status at the TOS. Money is sometimes collected in one department but oftentimes must be transferred to another department within the patient’s account.
- Virtual Credit Cards – Client wants to opt out. Calls are required to opt-out and the Unpostable attached to the claim must be worked accordingly.
- Patient Refunds- Patients pre-pay for their out-of-pocket (OOP) expenses related to their treatment. Often times (due to deductibles and OOP max) the patient is owed a refund.
- Private Pay Adjustments – Currently patients who are self-pay or their insurance doesn’t cover TMS therapy are labeled as Private Pay. Each TMS Center sets their own private pay fees and may differ by patient. Adjustments must be kept up to date on these accounts.
Knowledge, Skill and Experience requirements for this job:
- Professional certification or formal training or certification in Medical Terminology, ICD-10 and CPT.
- Strong background in a multi-specialty professional billing environment.
- Thorough understanding of electronic payment, adjustment, and denial posting processes.
- Understanding of ERA, EFT issues and troubleshooting tactics
- Thorough understanding of all-payer websites including Medicare/Medicaid.
- The candidate must have a minimum of 3 years in medical billing with emphasis on payment or patient account-related financial issues including payment posting.