Billing Account Receivable Representative

Behavioral Health Network - Springfield, MA

Full-time

Springfield, MA

Nursing and Residential Care Facilities

About the position

Behavioral Health Network, Inc. (BHN) is seeking a dedicated and detail-oriented Healthcare Billing Account Receivable Representative to join our growing team. As a non-profit community behavioral health agency, BHN has been providing essential services to children, adults, families, and communities in Western Massachusetts since 1938. Our mission is to deliver comprehensive, outcome-driven behavioral health care that is high quality, affordable, and culturally appropriate for individuals of all ages and income levels in our constituent communities. In this role, you will be an integral part of our Healthcare Billing/Accounts Receivable (AR) team, responsible for reviewing and approving billing, investigating denials and explanations of benefits (EOB), and reconciling payment rates. You will conduct audits and reviews of assigned claims and denials, ensuring that both manual and electronic processing of a high volume of billing denials is handled efficiently. Your expertise in medical insurance billing and collections will be crucial in maintaining the integrity of our electronic health records (EHR) and ensuring that our billing processes are accurate and compliant. The ideal candidate will possess strong analytical and problem-solving skills, a keen attention to detail, and the ability to work independently in a remote setting. You will be expected to maintain daily and monthly routines while keeping accurate billing records and reports. Your role will also involve ensuring that accounts receivable (AR) is tracked effectively and that payers are compensating at the correct rates. BHN is committed to social justice and diversity, and we strongly encourage candidates from diverse backgrounds to apply.

Responsibilities

• Review and approve billing
• Investigate denial and EOB
• Understand Medicare and ACO/MCO's
• Reconcile payment rates
• Conduct audits and review of assigned claims and denials
• Process a high volume of billing denials both manually and electronically

Requirements

• High School Diploma or GED required
• Strong knowledge of medical insurance billing and collections
• Familiarity with CPT, ICD10, and HCPC coding and medical terminology
• Overall understanding of managed care products (HMO, PPO, ACO, MCO, etc.)
• Ability to work independently and remotely
• Ability to read and understand explanations of benefits (EOB)
• Strong working knowledge of Medicare and Medicaid benefits
• Strong analytic and problem-solving skills
• Good attention to detail
• Good team player
• Great attitude and time management skills
• Basic Microsoft Word and Excel competency
• Competency in keeping track of AR and ensuring that payers are paying at the right rate