Claims Analyst

The Institute for Behavior Change • Part-time • Exton, Pennsylvania, United States • $50 / hour • 3m ago

The Institute for Behavior Change is a non-profit company that provides treatment and support to children diagnosed with mental health disorders and their families. We were founded in 1997 and continue to provide quality services throughout Delaware, Montgomery, and Bucks County.

The Claims Analyst is a part-time, in-office position, with growth potential. The Claims Analyst is supervised and reports directly to the Chief Operating Officer and working closely with the Human Resources Director. This position is at our administrative office in Exton, PA.

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

Weekly electronic claims submission (ANSI 837p)
Account management – Post remittances, correct billing errors, resubmit corrected claims, reconciling invoices
Securing all required information for billing Third Party Liability (TPL) claims
Update billing Standard Operating Procedures as needed
Preparing reports as requested
Monthly client eligibility and enrollment checks
Perform special bookkeeping assignments as requested
Staff credentialing/NPI numbers/renewal process including CAQH support
Medicaid enrollment support for licensed providers

Schedule

10 hours per week in-office, as needed

Minimum Qualifications (Knowledge, Skills, and Abilities)

A minimum of two years related to medical billing, A/R and healthcare billing
Experience with Central Reach/EHR billing procedures strongly preferred
Experience with electronic billing for mental health services, especially Pennsylvania Medicaid (IBHS)
Familiarity with Medicaid billing standards set by CMS (especially pay-and-chase for Medicaid EPSDT claims)
Experience using clearinghouses (especially Availity, Waystar and OfficeAlly)
Experience and knowledge with medical data management - including HIPAA compliance
Experience with data entry and Quality Assurance practices to minimize data entry errors
Proficiency with MS Word, Excel and Adobe Acrobat
Exhibit confidentiality, discretion, flexibility, and willingness to work closely with our senior management team

OUR VALUES

We are committed to providing high quality mental health treatment and behavioral support to children in their homes, schools and communities (including daycare, camp and after-school care). Our staff learn state-of-the-art skills in behavioral treatment and assist parents in getting and keeping insurance funding until treatment is completed successfully. We provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, gender, sexual orientation, national origin, ancestry, physical or mental disability, or veteran status. Successful candidates align with our values:

Tell the Truth
Be Thankful
Help Others
Share Fairly
Move Forward

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