We are North Idaho’s premier provider of integrated medical, dental and behavioral health services. Our amazing care teams deliver world-class healthcare utilizing a patient directed, community-focused approach. Providing high quality, affordable Healthcare from the Heart is our passion. Our mission is to deliver a healthcare experience that provides hope, inspires change, and extends life for our patients and our community.

Top reasons to join our team:

• Our employees are mission – minded
• We are passionate about providing excellent patient care
• Community-focused
• Committed to a fun and supportive team environment
• We offer high-quality competitive employee benefits

Responsible for the timely completion of all billing functions including maintaining accurate record of all patient accounts, recording charges, payments, submitting reimbursement requests to all payers, and following up on any denials.

• High school graduate or equivalent.
• One (1) year experience of behavioral health or substance abuse billing or any equivalent combination of experience, training and/or education preferred.

Knowledge, Skills, and Abilities Preferred:

• Working knowledge of Behavioral Health and/or Substance Abuse Counseling coding.
• Experience with Idaho Medicaid Behavioral Health program, Optum.
• Working knowledge of CPT and ICD10 codes as well as medical terminology.
• Up to date with health information technologies and applications.
• Skill in establishing and maintaining effective working relationships with other employees, patients, organizations and the public.
• Ability to read and interpret insurance explanation of benefits.
• Ability to communicate effectively in writing, over the phone, and in person.
• Proficient in the Microsoft Office including Outlook and Excel.
• Be service-oriented with the ability to pay attention to details in a fast-paced environment.

Duties and Responsibilities:

• Ensures that claims are submitted with a goal of zero errors.
• Timely follow up on insurance claim denials, exceptions or exclusions.
• Timely charge acceptance/processing and appending necessary modifiers.
• Verifies completeness and accuracy of all claims prior to submission.
• Balances claims between two software programs to verify accuracy.
• Reviews credit balances and takes action in a timely fashion.
• Utilizes monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.
• Responds to inquiries from insurance companies, patients and providers to include insurance eligibility.
• Timely communication to the Revenue Cycle Director regarding trends with payors/front desk and other issues that are potentially disruptive to cash flow.
• Continues education for claims processing with the Idaho Medicaid Behavioral Health Program, Optum and others.
• Identifies patterns of billing errors, inaccurate payments, posting errors and communicates any needed system changes to direct supervisor.
• Creates and maintains meticulous records of follow-up efforts via the billing system.
• Reduces overall delinquent patient AR.
• Understands and adheres to HIPAA and PHI guidelines.
• Makes necessary demographic changes to patient accounts to ensure accuracy for future billing.
• Provides professional and courteous customer service at all times.
• Accurately posts insurance and patient payments by line item with basic knowledge of insurance contracts.
• Ability to comfortably work with patients on income information for sliding scale and/or payment plans.
• Working knowledge of current grants, funds, and other programs available to patients for their healthcare at Heritage Health and beyond.
• Regular and predictable attendance is an essential function of this position.
• Performs other job-related duties as assigned