Billing And Coding Specialist/Clinical Intake Office Manager

Black Girl Health Foundation is looking for a Billing and Coding Specialist/ Clinical Intake Office Manager to work for its Outpatient Mental Health Clinic. The Specialist will need to utilize knowledge of insurance regulations, health insurance contracts, medical coding, and bookkeeping to perform a variety of revenue cycle support activities. These include but are not limited to coding, insurance verification, ensuring the accuracy of the information housed in the practice management system and submitting accurate claims to Optum Maryland.

ROLES & RESPONSIBILITIES

· Extracts relevant information from case records and acts as liaison to clarify information

· Examines documents for missing information; corrects information as needed

· Assigns CPT and ICD-10-CM codes

· Audits record documentation to identify miscoded and under/up coded services

· Performs chart audits and provides coding feedback and education to clinical team as needed

· Answers questions, advises, and trains providers and staff on medical coding

· Informs supervisor of issues with equipment and billing software, and serves as point person for billing software issues, complications and submits service tickets through Optum Maryland Incedo

· Ensures compliance with coding policies and guidelines; understands the application of each code set

· Maintains current knowledge regarding coding and diagnostic procedures

· Works towards compliance in all aspects of coding, participates in compliance activities as requested, and conducts/participates in provider coding reviews and education, as requested

· Follows HIPAA guidelines when accessing and sharing client information

· Maintains client and business confidentiality

· Provides timely and professional customer service, verify discrepancies by and resolve patient billing issues, answer questions from patients, facility staff, and third-party vendors.

· Supports, investigates and corrects rejected and denied claims

· Participates in educational activities and attend staff meetings

Assist with scheduling of appointments, obtaining financial and insurance benefit information, and informing new clients of critical information prior to first appointment

? Conduct brief clinical interviews with prospective clients to identify the reason for seeking treatment
? Collect information that includes but is not limited to their history, clinical information from the individual/family,
physical and mental condition
? Formulate a diagnostic impression, make recommendations regarding appropriate level of care, reason for
seeking treatment and determine whether the organization can provide services suited to the client’s condition
? Designate routing for intake/program assignments
? Coordinate intake services based upon client insurance information and verification
? Determine client financial plan, eligibility for financial assistance, and educate client on service fees, insurance
benefits and restrictions including co-payments, deductibles, pre-existing clauses, etc.
? Perform initial clinical record data entry by initiating new client charts
? Maintains the client waiting list as necessary. Regularly updates referral and the referral source of individual’s
status on the waiting list.
? Completes and submits all clinical and demographic intake information needed for I Can Notes and for
activation in the billing system.
? Ensures the mailing of admission letters to new clients and follow-up surveys to all discharged members.
? Participates in meetings to remain up to date on all organizational changes that may affect services available to
new referrals.
? Reviews outcome information and makes recommendations as appropriate
? Provide crisis assessments for all walk-in clients experiencing emotional distress or other crises
? Maintain confidentiality of records and information related to clients and their treatments.
? Utilize the resource manual as well as exhibit efficiency utilizing web-search engines to review and provide client
specific resources.
? Track client follow-up and clinical outcomes that is documented in I Can Notes
? Document in person and telephone encounters in I Can Notes and use the system to identify and reengage
clients who may be lost or no-shows to follow-up

· All other duties as assigned
Job Qualifications:

• Has extensive experience organizing resources and establishing priorities
• High school diploma required; associate degree preferred
• Ability to communicate effectively, both verbally and in writing
• Ability to maintain quality, safety and/or infection control standards
• Working knowledge of the operations and administration of a behavioral health clinic
• Knowledge of psychiatric rehabilitation programming and services
• Ability to develop and maintain record-keeping systems
• Knowledge of psychiatric rehabilitation procedures, regulations, and standards
• Thorough understanding of front office operations, including reception/registration, scheduling, determination of eligibility, prior authorizations and collection of co-pays/outstanding client balances
• Thorough knowledge of medical insurances and billing operations
• Ability to make effective administrative/procedural decisions and recommendations
• Skill in the use of computers with a Windows-based operating environment Behavioral Qualities
• Able to work effectively at all levels in a collaborative team environment to offer guidance and supervision in a constructive and appropriate manner
• Current CPR certification
• Previous administrative or clinical experience in a behavioral health program
• Excellent organizational skills
• Outstanding customer service and interpersonal skill

Job Types: Full-time, Part-time, Contract

Schedule:

• Monday to Friday

Experience:

• Medical Billers & Coders: 5 years (Preferred)
• billing and coding for a Maryland Health Company: 1 year (Preferred)

Work Location: One location