REPORTS TO: Operations Director 

HOURS/SCHEDULE: 20 hours per week 

BENEFITS: Eligible for Oregon Sick Leave which accrues 1 hour for every 30 hours worked, up to 40 hours per year.

LOCATION: SE Portland

WHO WE ARE:  At Calico Mental Health Associates, we provide warm, personalized, quality mental health care in private practice settings all over the Portland Metro Area.  The administrative office is in SE Portland. We pride ourselves on a “relationship first” approach with patients that is nurtured on an individual basis. 

WHY WORK HERE?

• We make a difference. If you place high value in taking part in positive change and assisting in others’ lives, you will have an opportunity to do that here at Calico on a daily basis. We support our patients with compassion, respect, and validation.
• We are committed to maintaining a positive and supportive culture for all employees.  It is a great place to learn and grow professionally.

Calico Mental Health is an Equal Opportunity Employer. We welcome and celebrate diversity in the workplace.

QUALIFICATIONS: A successful candidate for our Billing Support Specialist will have great attention to detail, strong problem solving skills and the ability to effectively communicate with patients, peers, management and the general public. Technical requirements include:

• High School Diploma or equivalent
• 2 + years experience in Mental Health billing
• Medical Billing and coding certification is a plus! 
• Experience with an Electronic Health Record systems and record keeping.
• Knowledge of HIPAA as it relates to medical billing and practices
• Knowledge of current CMS regulations related to coding and documentation.
• Ability to define problems, collect data, establish facts, and draw valid conclusions. 
• Must have proficient knowledge of Microsoft Office 365

DAY-TO-DAY: A typical day in this role will include providing assistance to patients and providers regarding billing, as well as managing the claim follow up process. Duties will include:

• Manage claims submission, follow up and account balance resolution
• Process insurance claims for insurance reimbursement
• Submit primary and secondary insurance claims electronically and on paper
• Enter charges accurately and expeditiously to ensure proper records handling and fast payment responses 
• Manage Medicare and Medicaid billing requirements, processes, and liabilities 
• Work with clients to develop self-pay arrangements and payment plans; Provides financial counseling to providers and patients regarding billings, co-pays, patient statements and collections 
• Assists with patient inquiries regarding pre-authorizations and referrals for requests by providers for recommended treatments outside of the providers’ scope
• Manage client’s insurance benefits
• Process and follow up on payer denials, consulting with the client and/or their family as needed 
• Post payments in a timely manner 
• Initiate private pay collections after insurance cancellation, denial, or other issue 
• Research and resolve client billing problems or issues 
• Document payment records and payment issues as they occur
• Acts as a liaison between patients, other entities to resolve billing errors in patient statements; assist with appeals as necessary 
• Tracks encounters for uninsured patients for retroactive billing
• Supports the review of billing change requests that need to be done and follow explicit instructions for code updates for coding changes. Tracks changes as needed.  
• Acts as back up to Practice Support group
• Review, track and generate analytical reporting for insurance revenue diversification, average collection per visit, provider revenue estimates, billing projects, billing cycle and other reports at the request of the Operating Director 
• Creates, writes, and runs reports for clinical data requested by Executive Leadership Team 
• Provides coaching and training on insurance verification and coding responsibilities to providers and billing support and practice support team