Job Description:

The incumbent of this position is responsible for supervising the collection, posting, and management of account payments as well as overseeing the claims submissions and ensuring staff follow up with insurance companies.

Essential Job Functions:

Complete supervisee’s performance evaluations, training plans and supervision records.
Facilitates processes to ensure accurate and timely claims submissions.
Completes audits on staff reports relating to claim denials and non-payments.
Maintain an accurate, up-to-date reporting system providing information on insurance billings, processing time lines, verifications, pre-certifications, reasons for denial and payment of filed claims on a daily basis.
Monitor pay habits of contracted insurance companies as well as out-of-network reimbursements and reports this to Director of Insurance Billing quarterly in order to assist in determining need for additional or re-negotiated contracting.
Assure efficient day to day operation of all commercial billing functions by troubleshooting problems, spot-checking systems for accuracy, and providing day to day technical assistance to staff.
Verifies and approves commercial refund requests and ensures staff follow up on any unpaid or denied claims. Communicates status of appeals to Director of Insurance Billing.
Assist with monitoring of receivable accounts for recommendations of collection, write-off, reimbursements, etc.
Runs quarterly reports to determine distribution of workload for commercial billing staff, and make amendments based on results.
Demonstrates interest in long term and short term goals and objectives of the company.
Other duties as assigned by the Director of Insurance Billing, Vice President, and/or Executive Team members.

Knowledge, Skills, and Abilities:

Considerable knowledge in medical billing and collection practices.
Basic knowledge of medical coding and third-party operating procedures and practices.
Superior communication and customer service skills.
Excellent 10 key and alphanumeric data entry skills with attention to detail.
Proficient in common word processing, spreadsheet, database, and web based applications.

Experience and Education Qualifications:

Graduated from an accredited college or university with a Bachelor’s Degree in a health or human services, business, psychology, or related field; OR
High School diploma with courses in typing and business practices AND
At least three (5) years’ experience in an insurance billing or bookkeeping position.

Supervisory Requirements:

Communicate the strategic direction of the organization and encourage participation by all team members.
Provide leadership and guidance to all aspects of the department.
Take an active role in monitoring the identification, development, and execution of strategic objectives.
Involve, as appropriate, all team members to achieve goals.
Effectively communicate to team members any changes and newsworthy events within the department or company.
Handle difficult team member situations directly, using appropriate discretion and Human Resource advice to show respect for the individual.
Champion change and effectively manage the implementation of new ideas.
Reinforces team approach throughout functions; support and solicit input from team members at all levels within the company.

Employment Requirements:

Successful completion of background check including criminal record, driving record, abuse/neglect and fingerprint check.
Completion of New Hire Orientation at the beginning of employment.
All training requirements including Relias at the beginning of employment and annually thereafter.
Current driver’s license, acceptable driving record and current auto insurance.

Physical Requirements:

ADA Consideration - Sedentary work: Exerting up to 10 pounds of force occasionally (exists up the 1/3 of the time) and/or a negligible amount of force frequently (exists 1/3 to 2/3 of the time) to lift, carry, push, or pull, or otherwise move objects, including the human body. Repetitive movements of hands, fingers, and arms for typing and/or writing during work shift.

Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.

Position Perks & Benefits:

Paid time off: full-time employees receive an attractive time off package to balance your work and personal life.

Employee benefits package: full-time employees receive health, dental, vision, retirement, life, & more.

Top-notch training: initial, ongoing, comprehensive, and supportive.

Career mobility: advancement opportunities/promoting from within.

Welcoming, warm, supportive: a work culture & environment that promotes your well-being, values you as human being, and encourages your health and happiness.

Brightli is on a Mission:

A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance user care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients.

As a behavioral and community mental health provider, we value diversity, equity, and inclusion in our workforce and encourage applications from individuals from diverse backgrounds and experiences. If you are passionate about empowering your local communities and promoting health equity, we invite you to join our mission-driven organization that is committed to building a diverse, equitable, inclusive and authentic workplace.

We are an Equal Opportunity and Affirmative Action Employer, and encourage applications from all qualified individuals without regard to race, color, religion, sex, gender identity, gender expressions, sexual orientation, national origin, age, marital status, disability or veteran status, or to other non-work related factors.

Places for People is a Smoke and Tobacco Free Workplace.

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