Essential Responsibilities

Claim Processing

• Review the electronic explanation of benefits from the insurance company, post the contractual obligation, the client liability, and payment received to the client’s account.
• Works in conjunction with the access team to ensure clean billing.
• Balances daily batches and reports.
• Review insurance payments for accuracy and compliance with contract discounts.
• Post insurance payments within the Electronic Health Record (EHR) accurately and timely.
• Contact insurance companies regarding payment discrepancies on moderately complex payment variances.
• Ensure claim timely filing deadlines are achieved.

Denials

• Investigate, resolve, and respond to behavioral health insurance claim denials which involve research, analysis, and problem-solving.
• Research and appeal denied claims.

Client Invoicing

• Generate reports and reviews to ensure the accuracy of client statements.
• Assist with sending our paper statements.

Work on special projects that increase efficiencies, improve workflows, and resolve issues that deliver positive financial impact.

Administer routine maintenance and standard EHR functions.

Position Requirements

Required Education, Certification, and Experiences

• Experience in accounting, finance, medical coding or related field preferred.
• Experience in healthcare billing preferred.
• Must pass a criminal background check through MN DHS NetStudy.
• Free from substance use problems for a period of no less than 2 years.