Billing Services Assistant-Outpatient Mental Health Office

Position Opening: Billing Services Assistant, Outpatient Mental Health Clinic

Job Details: Billing Services Team member, Insurance Verifications, Claim Submission, Monthly Invoicing, Payment Posting, Aging Accounts, Collections, Exceptional Customer Service

Job type: Administration, Full-time position

Salary Range: Available Upon Request

Number of openings for this position: 1

Office Schedule:  Monday-Thursday 7:30 am-4:30 pm, Friday 8:00 am-2:00 pm

Office Location: La Crosse office

JOB PURPOSE

The Billing Services Assistant is responsible for providing exceptional customer service, submitting clean claims, sending out monthly statements, posting payments to accounts with accuracy, working bad claims, monitoring collections on outstanding accounts for all lines of business for the company in accordance with rules and regulations for a fast paced and growing mental health counseling clinic. The position will work with a team to complete tasks and responsibilities of the billing department.

GENERAL RESPONSIBILITIES AND DUTIES

• Correspond with clients, insurance companies, social workers, and others by phone, in person, or through electronic media.
• Respond to tasks and requests in a timely manner (team members, team leaders).
• Ability to stay organized, attention to detail and accuracy a priority.
• Use a personal computer and a variety of office software applications including word processing, email, and file management. Prepare documents in Google Word/Documents from scratch or using predefined templates and form letters. Create or maintain files in Google Sheets.
• Operate other office equipment such as printers, copy machines, and fax machines. 
• Assist in resolving problems and ensuring satisfactory customer service.
• Fax, scan, email, and copy documents.
• Update and maintain databases/documents. 
• Use Therapy Appointment billing software to enter and update client data in a timely fashion. 
• Use BambooHR time tracking software daily to enter time worked for payroll. 
• Adhere to PHI and HIPAA regulations.

ACCOUNTS RECEIVABLE

• Post payments accurately to billing systems.
• Review daily reconciliation of previous business days. 
• Monitor unpaid invoices and client accounts and follow-up in a timely manner.

BILLING ADMINISTRATION

• Create and submit invoices and post payments for record requests, school-based mental health (SBMH) services, managed care organizations (MCOs), and comprehensive community services (CCS).
• Create and maintain the Over-the-Counter Log weekly for use as a tool by the office assistants.
• Verify insurance eligibility, provider network status, and claims addresses for all clients.

CCS AND COUNTY CONTRACTED BILLING

• Adhere to contract rules and regulations.
• Correspond with individual counties on requested revisions and payments.
• Monitor authorizations for renewal dates and notify providers with expiration dates in advance.
• Address outstanding claims and account for issues within 30-60 days of clean claim submission, follow the 90-day rule for payment.
• Prep CCS spreadsheets for end-of-month billing submission.
• Accurately document notes in TherapyAppointment (TA) memo section and alert section for all clients.
• Provide quality assurance checks for all CCS notes on a weekly basis and that they include the contract requirements for monthly billing. This includes all Outpatient CCS and all Family Services CCS notes. 
• Accurately complete the required CCS spreadsheet by client for each service array each month this includes, Psychotherapy, Individual Skill Development and Enhancement, Wellness Management and Recovery, and Psychoeducation. 
• Monitor all CCS Service Plans so units do not go over allotted amounts, as we do not get paid for services that are not pre-approved/authorized by the Service Facilitator.
• Treat CCS corrections as urgent and complete in a timely manner. This includes communication between providers and provider’s supervisors. 
• Manage the WorkflowMax (WFM) billing system and make necessary adjustments and updates, (ie, first of year rate changes once approved by the Clinic Administrator and Billing Services Manager.)
• Submit chart notes and CCS invoice spreadsheets to the correct email address, document the date and time billing information was submitted.
• Create invoices in WFM for county clients and submit them to the correct payer, document the date and time billing was submitted.
• Review the Billable Time Report in WFM after all CCS and county billing is complete. 
• Complete specialized reports or projects requested by the President and/or Clinic Administrator and/or Team Leader.
• Post payments accurately in the correct billing system, update spreadsheets with payment information.
• Monitor unpaid invoices and client accounts and follow-up in a timely manner.

SCHOOL-BASED MENTAL HEALTH BILLING

• Submit invoices to school districts monthly for services provided.
• Post payments in the correct software.
• Follow up on past due balances.

TIMESHEETS

• Review outpatient therapy team timesheets weekly for accuracy and ensure revisions are completed accurately.

CREDENTIALING SERVICES

• Address questions from the Office Assistants regarding in-network status of providers.
• Update BambooHR with any credentialing approvals/denials received.
• Notify the Office Assistants when they are able to schedule a new insurance for a provider.
• Update the Provider Network Chart as needed.

INCLUSA AND MYCHOICE WISCONSIN (Managed Care Organizations)

• Receive authorizations via fax, email, or portal from Inclusa and MyChoice Wisconsin.
• Create and maintain the authorization spreadsheet.
• Contact Office Assistant Team regarding provider assignment for new referrals.
• Send authorization information to the provider via email. 
• Enter authorization information into TA notes and WFM, scan into TA docs.
• Notify providers when authorizations will be expiring and get information for new/updated authorizations.
• Create a monthly spreadsheet for payment of MCOs in-home and outpatient counseling client claims for collateral contact, paperwork, and/or travel. 
• Review authorization number.
• Scan claim forms into the correct file in the billing team drive.
• Submit clean and accurate claims.
• Post payments received in the correct billing system, TA or WFM.
• Research and determine how to correct claims that have been denied by insurance or another payer.
• Document communication with insurance companies, social workers, etc each time a call/email is made/received.
• Meet with the Billing Services Team Leader as needed to review and resubmit denied claims.
• Send insurance refund requests from insurance companies to the Billing Team Leader. 
• Review and monitor the Accounts Receivable (AR) Aging Report for Inclusa from the WorkflowMax (WFM) billing system. 
• Address outstanding claims and account for issues within 30-60 days of clean claim submission, follow the 90-day rule for payment.

CLAIM SUPPORT

• Submit correctly coded commercial, Medicaid, and Medicare claims electronically or via paper in a timely manner.
• Effectively and efficiently work bad claims and resubmit for payment. 
• Be aware of claim submission deadlines (90 days for clean claim).
• Submit secondary claims with appropriate primary insurance EOB.
• Effectively and efficiently work bad claims and resubmit for payment.

COLLECTIONS

• Check client accounts for patient responsibility and send statements by mail or through the client portal at the beginning of each month.
• Send payment plans and credit card authorizations to clients with outstanding balances, as necessary.
• Review and monitor accounts for collection.
• Send collection letters to clients with balances greater than 90 days.
• Call clients for payment.
• Report delinquent accounts to Credit Bureau Data as assigned.
• Accurately document client contact in billing systems.

EMPLOYEE ASSISTANCE PROGRAM (EAP)

• Verify authorizations for EAP sessions and ensure that paperwork is received from the EAP

company.

• Monitor EAP authorizations for each client and provider.
• Review EAP paperwork to ensure it is accurate and complete.
• Submit claims according to requirements for each individual EAP company.
• Post payments received.
• Follow up on claims that are not paid in a timely manner. 

SPECIAL PROJECTS AS REQUESTED

• Complete specialized reports or projects requested by the President and/or Clinic Administrator and/or Team Leader.

KNOWLEDGE/SKILLS

• Employ effective telephone and interpersonal communication skills.
• Possess competency, proficiency, and accuracy with data entry and managing various computer software programs.
• Demonstrate effective organizational and planning skills.
• Possess spirit of teamwork and assist team members as needed.

• Must be flexible, reliable, and adaptable to meet the needs of the company.

• Consistently make sound decisions and problem solve effectively.
• Communicate professionally with clients, supervisors, peers, and persons outside the 
• organization.
• Resolve conflicts and effectively employ negotiation skills with others. 
• Possess basic knowledge of computers (Chrome, Google docs, Google email, Google 
• spreadsheets,  internet, etc) as well as typical office equipment (copier, fax, scanner, etc). 
• Possess the ability to work independently, including organizing, planning, and prioritizing work.
• Maintain emotional control under stress.
• Follow company confidentiality procedures. 
• Follow HIPAA guidelines, complete yearly training.

WORK ENVIRONMENT

• General office environment
• Office work is generally sedentary in nature, and will require standing and walking part of the time
• Work is generally performed within an office environment, with standard office equipment available. 
• Business casual attire
• This position will also provide support to the Office Assistant team when coverage is needed to fill vacancies at the front desk.

EDUCATION AND EXPERIENCE

High School diploma required; preference given to candidates with a college education and/or Associate's Degree in the human services field. Billing knowledge and claim submission helpful for primary and secondary insurances and posting experience, preferably in a health or human services setting, dental office, medical office, or related health service oriented environment. The ideal candidate will be able to provide exceptional customer service, to work under pressure, handle multiple tasks, be comfortable and knowledgeable with online insurance portals, have attention to detail, take direction and follow directions, and prioritize workload. Computer experience with Mac and Google preferred. EOE.

SUPERVISED BY: This position will report to and is supervised by the Billing Services Team Leader

ONALASKA OFFICE HOURS: M, T, W, TH  8:00 a.m. to 6:00 p.m., F 8:00 a.m. to 2:00 p.m.

FTE BILLING POSITION HOURS LA CROSSE OFFICE: Monday-Thursday 7:30 a.m. to 4:30 p.m., Friday 8:00 a.m. to 2:00 p.m.

Join Our Team: We are looking for an energetic and positive individual to join our billing team.  As part of this team you will submit billing claims and invoices to the appropriate payer, verify authorization of services, monitor account balances, and follow up on past due balances.  You will accurately post payments and correct and resubmit denied claims in a timely fashion. In addition, you will work with an array of commercial insurances and Managed Care programs.  Frequent contact with clients by phone, text, and email, as well as contact with providers, office staff, and case managers will be a large part of your responsibilities to provide exceptional customer services. If you have strong organizational skills, a positive attitude, are flexible and able to work independently, and want to be part of a strong and dedicated team, send a cover letter and resume to BambooHR.

Company: Stein Counseling and Consulting Services, Ltd. is a small, fast paced, growing business with the needs of the communities we serve, family-oriented outpatient mental health business located in Onalaska and La Crosse, Wisconsin.  For the past 24 years, we have been providing services to clients of all ages with a wide range of needs. When you join the Stein Counseling family you will belong to a group of professionals who are inclusive, hard working, and caring.  

Stein Counseling offers the following benefits:

• Paid time off
• 401K with an employer match
• Flexible spending account
• Employee Assistance Program
• Regular meetings with the team leaders and team members, quarterly check ins
• Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

Other employee paid options available to allow you a work-life balance and personal care:

• Delta Dental and Vision Benefits - group savings
• Supplemental Health-Related Insurances including: 
  • Accident Insurance (work or non work related)
  • Critical Illness Insurance
  • Cancer Protection Insurance
• Short-term disability 
• Whole Term Life Insurance