Senior Billing and Collections Specialist

At ROWI Teen & Parent Wellness Centers, we are dedicated to transforming the lives of adolescents struggling with mental health issues.

Why ROWI?

• Culture of Care : We pride ourselves on a supportive and collaborative work environment where your well-being is a priority.
• Work-Life Balance : Embrace a balanced professional life with no evening or weekend shifts, encouraging a healthy work-life harmony.
• Fun and Fulfillment : Enjoy a workplace where fun and professional fulfillment go hand in hand, ensuring every day is rewarding.
• Comprehensive Benefits : Benefit from competitive packages including healthcare, PTO, sick leave, and 401k matching, supporting both your personal and professional growth.

Full job description

The Senior Billing and Collections Specialist is responsible for monitoring claim status, researching rejections and denials, documenting related account activities within CollaborateMD, posting adjustments, and assisting with collections from commercial insurance payers. The Senior Billing and Collections Specialist must possess critical thinking and problem-solving skills with an understanding of commercial insurance payer payment methods to correctly record contractual adjustments based on payer contracts. In addition, the Senior Billing and Collections Specialist must demonstrate proficiency within the billing system to ensure all functionality is utilized for efficient processing of claims in a timely manner.

Duties and Responsibilities :

Perform follow up with Commercial insurance companies on unpaid insurance accounts identified through claims report in CollaborateMD.

Utilize CollaborateMD and KIPU to research, investigate and record findings to get claims processed and paid properly.

Assist with submitting claims, follow-up of claims, and initial billing setup of clients.

Must have written appeals process experience

Responsible for applying Single Case Agreements to an account during the collections process. Must be able to identify the difference between electronic and paper submissions in CollaborateMD.

Responsible for applying benefit verification information to the collections process.

Ability to handle a large volume of outbound insurance calls for the purpose of claims follow up.

Responsible for entering detailed notes that clearly follow the claims process from submission to final posting, including Explanation of Benefits (EOB) Page 1 reconciliation, processing denial of claims and providing required documentation.

Responsible for collection and / or re-submission of claims by communicating information to supervisor and biller in a timely manner.

Prepare appeal letters on company letterhead

Communicate with the Strategic Revenue Cycle Manager to identify and resolve audit review issues.

Communicate daily with insurance companies via phone and written communication to answer / respond to correspondence related to patient accounts and answer billing and change related inquiries;

Maintain patient information confidentiality pursuant to HIPAA compliance.

Attend designated staff and in-service meetings.

Any additional duties as assigned by the management team.

Other Related Skills and Abilities :

Working knowledge of CollaborateMD and KIPU required

Private insurance experience required (Behavioral Health preferred)

Must have critical thinking skills

Proficient in Excel

Working knowledge of CPT / revenue codes preferred

Working knowledge of commercial insurance carrier billing requirements

Ability to read and understand EOB's

Ability to work with In-Network and Out-of-Network carriers

Ability to manage time effectively.

Ability to work with minimal supervision.

Proficient in basic computer skills.

Able to maintain clear boundaries with clients and staff.

Work effectively within an interdisciplinary team environment

Basic Education and Experience Required :

Minimum of a high school diploma required.

Knowledge of business and accounting processes within mental health billing capacity.

3-5 years of mental health billing experience required

Knowledge / Competencies :

Strong interpersonal and organizational skills.

Excellent written and verbal communication skills.

Ability to set priorities and handle multiple assignments.

Must exercise discretion with billing information.

Able to present and manage cases in a knowledgeable and professional manner.

Must be able to communicate with people from all educational and cultural backgrounds.

Must cope constructively with stressful situations.

Must demonstrate tact, initiative, resourcefulness, professional manner, enthusiasm, and non-judgemental attitude.

Documents clearly and efficiently.

Join Team ROWI :

Step into a role where you can truly make a difference. At ROWI, we are committed not only to the well-being of our clients but also to the professional and personal growth of our team. Join us in a fulfilling, engaging, and balanced work environment where each day brings new opportunities to impact lives positively.

Job Type : Full-time

Pay : $30.00 - $32.00 per hour

Benefits :

401(k)

Dental insurance

Health insurance

Paid time off

Vision insurance

Education :

High school or equivalent (Required)

Experience :

KIPU : 1 year (Required)

CollaborateMD : 1 year (Required)

mental health billing : 3 years (Required)

Work Location : In person

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