Behavioral Health Billing Specialist In House Hybrid

We are an outpatient substance use disorder service provider contracted to serve individuals within Oregon Health Plan CareOregon, Trillium and DMAP and Out of Network for a variety of private insured plans as well as self pay. In network for CIGNA and MODA.

We are seeking an individual (not an agency) living in the Portland, Oregon area who has extensive experience with insurance billing and credentialing; specifically, for mental health and substance use disorder treatment services provided by non-licensed professionals (CADC’s) through an OHA certified facility. Also, familiarity with government contract administration- ex: Intoxicated Driver Program Fund, Multnomah County Health. 
BILLING SPECIALIST DUTIES:
-Verify insurance eligibility for benefits, Deductibles and Out of Pocket balances, pre- authorizations, primary and secondary coverage and update in client record in Reliatrax.
-Review and submit claims from EHR through Office Ally or another Clearinghouse
-Prepare report of various payer EFT payments for bookkeeper to reconcile in QuickBooks if needed.
-Retrieve EOB’S online, from Provider and post payments to the appropriate patient accounts, applying write offs or adjustments.
-Assign appropriate ICD 10, HCPCS Modifiers and CPT codes to maximize payments for agency with out of network insurance plans.  
-Assertively research denials and timely resubmit claims according to payment remittance advice and ever changing NCC edits
-Perform Medicaid crossovers and submit claims as secondary or tertiary insurances after the primary has paid.
-Assist and perform credentialing, re-credentialing apply for EFT
-Experienced with setting up and managing a facility  CAQH account along with individual accounts

COMPUTER PROGRAM SKILLS:
-Microsoft Office (Word, Excel, Outlook) Google Docs, Gmail, Sheets, Reliatrax EHR,
-Proficiency in use of multi carrier websites including: OHP/MMIS, PhTech, Onehealthport, Office Ally,CareOregon HealthTrioConnect UHC/Optum and Availity, CAQH. 
ADDITIONAL SKILLS/DUTIES:
-Review previously submitted claims over the year for errors and resubmissions. 
-Consulting on various compliance issues and other duties related to the position.
-Respond to agency request for individualized reporting for contract and grant requirements
-Support transitioning from previous billing specialist agency as needed

PLEASE READ: Preference to people with experience working directly with Oregon OHP, state contracts and Behavioral Health billing. 

HOW TO APPLY: Send email with resume attached to Executive Director at   [email protected]  with  “Billing Specialist Position” in the subject line. 
In the body of the email Include a brief description of your experience and contact information about how you can be reached for a brief initial interview.