Revenue Cycle Billing and Credentialing Specialists
Posted Aug 2
Headquarters: Boston, MA
Break healthcare with us … then help us fix it.
Are you a passionate, driven, smart and very social person who’s not afraid to take on new challenges? Do you want to be part of an established leading healthcare company with startup energy but where you don’t have to be a software propeller head with a waxed handlebar mustache, in a plaid shirt and skinny jeans rollin’ a fixie bike with a picobrew growler sling? Are you looking for a company where no one will ask you “what kind of animal would you be?” Are you looking for a place that rewards drive, performance and team play? Are you looking for a team that is working to do something truly great and to have fun in the process? Then a job on our rapidly expanding team at Column Health might be for you.
We’re seeking several Full or Part Time team members to join our revenue cycle team as credentialing specialists, billing & coding associates, and general revenue cycle specialists.
We are a mental health multi-clinic system seeking a team member to act as a billing/coding specialist to assure proper billing and coding for accurate claims reimbursement.
And we are additionally seeking a credentialing specialist to ensure proper credentialing and paneling of our clinicians with agencies and payors.
This job might be for you if:
- You admit when you don't know the answer, but you enjoy digging in until you find it and you ask for help when you need it
- You don't get flustered easily
- You like helping people and want to make a difference
- You are motivated and wish your job had more purpose
- You are patient, level headed, and Cool Hand Luke under pressure
- You pay attention to the details… all of them
- You have a voracious appetite for learning new things, and learn quickly
- You recognize that places that say they’re innovative or entrepreneurial aren’t necessarily
- When things change or you don’t have all the info, you roll with it
- You communicate clearly and eloquently, both verbally and in writing
- You’ve ever described a mullet on an aggressiveness scale
- You’ve done the gesture to “drop the mic” at some point in a conversation
- You can explain just about anything to anyone
- Phones don’t scare you
- You like making lists
- You hit new problems before being asked to
- You take ownership without stealing credit
- You want a job where you’re helped to excel into the next job up
- You want a job that’s not a job as much as it is a mission
Primary Objectives of the Revenue Cycle Specialist:
- The Revenue Cycle Billing Specialist is responsible for managing the internal and external insurance claims submission, posting and appeals process so that Column Health is paid quickly and accurately by third party insurers for services performed and ensuring that clinic staff is kept apprised of patient-related issues.
- Revenue cycle billing staff are also responsible for understanding and communicating changes in insurer claims policies, identifying additional procedure codes that Column Health can properly submit and ensuring that Column Health effectively utilizes all available resources to make the insurance verification and claims process as effective as possible.
- Revenue Cycle Credentialing Specialists are responsible for credentialing all new clinicians with payors and agencies, as well ensuring current clinical staff remain compliant with credentialing requirements.
- Insurance Claims Submissions- Daily for each clinic assigned.
- Review claims for proper ICD-10 diagnosis codes prior to submission
- Submit claims electronically via Athenahealth
- Post EoBs and ERAs- Daily for each clinic assigned
- Accurately post all EoBs/ERAs
- Make notations in claims history notes on appeals or unexpected claims activity so Revenue Cycle Specialist can communicate with patient
- Manage all aspects of Insurance A/R, including Denials, Underpayments, Non-Payments, Appeals, Resubmissions, etc.
- Monitor Insurance A/R and investigate unpaid claims
- Identify and track denied and underpaid claims and follow up and repeal results
- Investigate, correct and resubmit denied claims and track them in a timely fashion
- Refine and expand Column Health appeal letter templates
- Monthly Patient Statements
- Review monthly statements with Revenue Cycle Specialist prior to electronically sending to identify potential unexpected patient balances due to insurance denials, underpayments, etc.
- Communicate with Clinic Managers
- Review of problem claims and status of appeals/resubmissions
- Make notations in patient billing charts on unexpected insurance matters
- Maintain/Update Fee schedules in Athenahealth when payors update clinic fee schedules
- Work with all new clinicians to ensure proper credentialing
- Work with Column management to identify billing and revenue opportunities for both existing and new modalities of care
- Other tasks as assigned
- Stay informed of insurance claims news and policy changes at various payors
- Stay up to date on trends in billing and coding; identify and attend periodic relevant continuing education courses
- Maintain and update logins for various billing and collection sites (MA Virtual Gateway, BCBS Provider Gateway, etc.)
- Work with bookkeeping staff to resolve questions regarding insurance deposits
- Assist with credentialing matters to ensure smooth claims submission process
As a member of the Column Health clinic team, you’ll help us build a completely disruptive model of care and technology in an area of U.S. healthcare that is profoundly broken, and tragically inadequate – mental health and addiction treatment; you will be a part of something important. We are a young, fast-growing startup and with us, you will shift from having a simple title with limited responsibilities to having a role to play with unlimited possibilities.
- A BS/BA degree from an accredited college/university and know that it’s just a piece of paper
- Preferably experience working with Athena software.
- A lot of energy… a lot… and know how to use it
- A brain and know how to be useful
- A heart and know how it can used
- Perhaps some languages you speak beyond English
Just make sure we can see where you’ve picked up your super powers of awesomeness and capacity to help people when writing your cover letter.
Give us a couple references of people who can vouch for you
- Very competitive compensation
- Great benefits
- Great flexibility around where you work
- An amazingly fun work environment
- And a job where you save lives