Behavioral Health Billing Specialist

For 53 years Fair Haven has been a  health care leader in our community focused on providing excellent, affordable primary care to all patients, regardless of insurance status or ability to pay. Fair Haven is proud to have a diverse and motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients. 

We are seeking a Behavioral Health Billing Specialist. The Behavior Health Billing Specialist works with the Billing and Behavior Health departments ensuring all claims are reviewed for accurate documentation, submission and reimbursement.

Duties and responsibilities

The Behavior Health Billing Specialist maintains the professional reimbursement and collections process for the Behavior Health Program. Typical duties include but are not limited to:

• Reviews medical record documentation to determine appropriate ICD-10-CM/CPT codes and modifiers in accordance with official coding guidelines.
• Codes in accordance with coding and departmental guidelines. Maintaining no less than 93% accuracy in choice of codes, as observed in quarterly auditing.

Prepares by review the submission of clean claims to various insurance companies including but not limited to; carrier, guarantor, place of service and servicing provider

• Works claims and claim denials to ensure maximum reimbursement for services provided
• Uses department resources regularly and follows workflows, with minimal assistance or intervention, to perform daily work to meet daily metrics.
• Works with peers and/or leadership to create and maintain accurate up-to-date policies and procedures.
• Perform other related duties that may be inclusive, but not listed on the job description

Qualifications

• Minimum of a High School Diploma or GED and a minimum of one year of experience in a medical/behavioral setting.  The ideal candidate must have one year of Behavior Health billing and documentation review experience.

Previous leadership experience and a Certified Professional Coding (CPC) certificate through AAPC or other national recognized agency or willingness to obtain is preferred.   Experience in a Federally Qualified Health Center and being bilingual in English and Spanish is highly desirable.

The selected candidate will have the ability to work in a team environment or independently; to meet all established deadlines, metrics and assignment goals; have oral and written proficiency in English and proficiency with computer applications and multi-lined telephones.

American with Disabilities Requirements:

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.

Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.