Accounts Receivable Billing Specialist at SummitStone Health Partners

Accounts Receivable Billing Specialist

• Salary Range: $24 - $24.80, based on relevant years of experience
• Location: Larimer County, CO 
• Status: Full-time, 40/hrs. week

Role Overview:

The Accounts Receivable Billing Specialist is responsible for timely billing and follow-up of insurance claims for behavioral health, substance abuse, and medical services across several service lines offered at SummitStone Health Partners.  This includes management of denials, appeals and refunds all the while maintaining accuracy, compliance, and productivity standards. 

Essential duties:

• Timely billing submission of electronic and paper claims to payers. 
• Resolves billing edits related to coding, charging, and other billing issues. 
• Creates monthly client billing invoices to payers who do not accept UB-04 or 1500 billing.  
• Timely follow-up on claims and payment status.
• Follow-up on denials for outstanding accounts and submitting appeals when necessary to maximize collections where possible.  
• Ensure that all past-due client accounts are researched and resolved, utilizing payer portals for benefit verification, claims, and payment status.
• Ensure the proper order of filing claims to primary, secondary, and tertiary payers, moving balances to client responsibility after other payer sources are exhausted. 
• Receive and respond to phone calls and correspondence with questions and requests for information from customers (internal and external) and work collaboratively with other staff, clients and/or external third-party payors in a courteous, timely, and accurate manner.
• Fully learn, understand, and maintain knowledge of the Revenue Cycle Management department functions.
• Serve as direct back-up support to peers.
• Maintains regular and consistent attendance.
• Meet defined department goals for productivity, AR days and other Key Performance Indicators
• Promotes, supports, and demonstrates SHP’s mission, vision, and values through both behavior and job performance and adheres to policies, procedures, Compliance Plan and Standards of Conduct on a day-to-day basis.
• Effectively interacts and communicates with other SHP staff/clients/customers/partners/etc.
• Perform other duties as assigned.

Job Requirements:

• Detail oriented, with high-level problem solving, analytical, and investigational skills 
• Ability to work well independently, as well as in a team setting.  
• Excellent written and verbal communication skills
• Problem-solving and organizational skills 
• Proficient in Microsoft Office (Outlook, Word, Excel, and Power Point)
• Knowledge of CPT and ICD-10 codes, medical terminologies, billing software, and electronic medical records
• Understanding of industry-specific policies, such as HIPAA regulations for health care

Required: 

• Two years of experience in healthcare billing or similar billing of third-party payor claims.
• Knowledge of Medicaid regulations and CMS documentation standards.
• Excellent interpersonal and communication skills.
• Attention to detail.

Preferred:  

• Experience working with Colorado Medicaid will be an advantage.
• EPIC experience a plus.
• Preferred associate degree in business, medical billing or related field, or equivalent experience in healthcare/medical insurance environment.
• Previous mental health experience preferred, but not required.
• Bilingual/bi-cultural preferred.

Some positions include driving a company vehicle and require a valid Colorado driver’s license. 

At SummitStone Health Partners, we strive to foster trust, empower recovery, and inspire hope to strengthen and enrich our Northern Colorado community. 

We need your help to make this vision a reality.  

We are committed to fostering a diverse and inclusive environment where everyone can be their authentic self. We actively seek team members with a variety of backgrounds, identities, and experiences, and we honor the whole self—embracing differences in race, ethnicity, ability, age, gender, sexual orientation, spiritual beliefs, socioeconomic status, language, and the many intersections of identity. We invite everyone to be part of our journey and proudly serve as an equal opportunity employer.

Please visit summitstone.org for more information about who we are. 

Total Rewards

At SummitStone Health Partners, we are proud to offer a comprehensive and competitive benefits package designed to support the well-being of our team members. Eligibility and pro-rated benefit levels are based on FTE (full-time equivalent) status.

Below are some of the benefits we offer:

• Medical, dental, and vision coverage — including options for eligible dependents

• Mental health and wellness resources
• Short-term and long-term disability insurances
• Paid time off (PTO): Accrued vacation and personal leave based on FTE status and length of service
• Paid Sick Leave: Provided in accordance with the Colorado Healthy Families and Workplaces Act (HFWA)
• A range of voluntary benefits available to all employees

• 403(b) retirement plan with employer matching contributions

Reach Out

SummitStone will provide persons with disabilities with reasonable accommodations. If reasonable accommodation is needed to participate in the job application or selection process, please let your recruiter know.

Questions?  Please email us at [email protected]. 

 This position will be open for a minimum of three days and/or until a top candidate is identified.