Job Description:

Job Summary:

The incumbent of this position is responsible for collecting, posting, and managing account payments as well as submitting claims and following up with insurance companies.

Essential Job Functions:

Creates insurance claims for all private insurance billing and submits claims in a timely manner following billing schedule.

Complete audits of all claims documentation to verify accuracy of charges related to appropriate diagnosis and codes prior to filing claims.

Maintain an accurate, up-to-date reporting system providing information on insurance billings, processing timelines, verification, 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 Leadership quarterly in order to assist in determining the need for additional or re-negotiated contracting.

Provides follow up on any unpaid or denied claims; submits appeals within industry time frames for denials.

 Communicates status of appeals to program site.

Deliver appropriate, timely reports to Supervisors and to the Executive Team members as needed regarding accounts receivables, claim status, etc.

Assist with monitoring of receivable accounts for recommendations of collection, write-off, reimbursements, etc.

Assist with the development of any new in-house computerized billing systems and client demographics databases.

Other duties as assigned by the Director, 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:

High School diploma with courses in typing and business practices; AND

At least three (3) years experience in bookkeeping position; AND

At least two (2) years includes experience in an insurance billing position.

Supervisory Requirements:

None

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 prioritize fostering a culture of belonging and connection within our workforce. We encourage applications from individuals with varied backgrounds and experiences, as we believe that a rich tapestry of perspectives strengthens our mission. If you are passionate about empowering local communities and creating an environment where everyone feels valued and supported, we invite you to join our mission-driven organization dedicated to cultivating an authentic workplace.

We are an Equal Employment Opportunity Employer.

Places for People is a Smoke and Tobacco Free Workplace.