Hybrid Outpatient Credentialing, Contracting, and Billing Manager bei NOVA Behavioral Health
NOVA Behavioral Health · Greenville, Vereinigte Staaten Von Amerika · Hybrid
- Professional
- Optionales Büro in Greenville
Description
NOVA Behavioral Health
Greenville, NC
Full-time
NOVA Behavioral Health is looking for a Outpatient Credentialing, Contracting, and Billing Manager to join our team of professionals. We are looking for someone that brings a positive and professional customer-service attitude to our business. If you are interested in joining a growing, successful company, then we want to talk to you!
What will your day look like as a Credentialing, Contracting, and Billing Specialist?
- Assisting the CFO and Program Director in fiscal management activities for the organization
- Managing billing of Medicaid and other entities for NOVA’s community behavioral health services
- Initial credentialing and contracting of providers, and maintaining provider contracts with payors
- Managing prior authorizations for NOVA’s community behavioral health services.
- Assisting the CFO and Program Director with the management of NOVA contracts with payors
What will you do as a Credentialing, Contracting, and Billing Specialist?
- Responsible for all billing and payments for NOVA’s community behavioral health services
- Resolve discrepancies in submitted claims, billings and collections, and reports potential problems
- Responsible for reporting insurance payments and patient responsibility payments
- Responsible for maintaining billing records on all patients
- Check insurance eligibility for patients and maintains updated insurance information, including co-pay amounts, in the EHR
- Communicate estimated patient financial responsibility in advance of scheduled services to patients/ guardians, other administrative staff and providers
- Prepare and send invoices and statements for patients
- Responsible for prior authorizations, including: Submitting and maintaining prior authorizations coordinating with patients and NOVA personnel to obtain all documentation needed to gain authorizations, and maintaining updated authorization documentation.
- Support the CFO and Program Director in the management, revision, and renewal of all NOVA contracts with payors
- Ensure that NOVA providers are appropriately credentialed with necessary payors including credentialing new NOVA providers as well as renewing credentialing for NOVA providers
- Credential and establish new locations with all payers
- Maintain and share contracted payer changes and information with Program Director, CFO and other appropriate individuals
- Provide correspondence and other clerical activities relative to all primary functions
- Maintain a harmonious working relationship with co-workers and communicates pertinent matters to management in a timely manner
- Assure that all fiscal standards, policies, and procedures are implemented, and informs the CFO and Program Director of potential errors, exceptions, or problems
- Complete other duties as assigned
Qualities
- Excellent computer skills
- Organized
- Detail oriented
- Good communication skills
- Team player
- Willing and excited to learn
- Self-motivated/Takes initiative
- Flexible
- Strong work ethic|
Requirements
- High School Diploma or equivalent
- Excellent computer and typing skills
- Attentive to detail
- Effective organizational and communication skills
Preferred Skills
- Associate degree
- Previous experience with medical/mental health billing highly preferred
- Previous experience as a Claims Analyst highly preferred
- Previous experience with insurance/payor contracts managing and maintaining contracts highly preferred
- At least one year of previous business experience highly preferred