Rite of Passage Behavioral Health Billing/Credentialing Specialist in Queen Creek, Arizona
The Behavioral Health Billing & Credentialing Specialist performs accounts receivable functions including billing, processing EOBs, applying payments, and collections of outstanding amounts. Qualifications include data entry skills, ability to analyzing complex information, is quality focused with a high productivity level. This position reports to the Director of Business Operations & Initiatives or other designated supervisor within the clinic.
ESSENTIAL FUNCTIONS:1. Verifies client eligibility with Medicaid/Insurance carriers. May assist in obtaining authorization for services asneeded.2. Works with departments to gather and review required billing information;3. Verifies accuracy and completeness of all required information needed for billing and payment;4. Bills Medicaid/Insurance carrier by inputting billing information to database; initiating electronic transmissions, etc.5. Monitors claims processing and payments;6. Reconciles all submitted and remitted bills. Resolves disputed claims by gathering, verifying, and providingadditional information; following-up on claims.7. Communicates with customers regarding their billing and assists in collections;8. Resolves discrepancies by examining and evaluating data; selecting corrective steps;9. Prepares monthly reports summarizing billings, adjustments, and revenues received;10. Performs credentialing and re-credentialing activities of all providers;11. Oversee the collection of all pertinent primary source verification needed for credentialing;12. Complete and process credentialing applications;13. Treats others with respect, confronts negative behavior and supports confrontations.14. Ability to prepare written reports and correspondence (in English).15. Ability to understand and follow verbal and written instructions (in English).16. Completes required reports and documentation in a timely manner, provides management with required reports andadvises of any problematic situations.17. Complies with and implements the Rite of Passage and Rite Path Policies and Procedures as detailed in theappropriate manuals/handbooks.18. Ensures the highest standards are maintained to prevent illegal, unethical, or improper conduct and to ensure theprogram remains in compliance with agency licensing and Rite of Passage and Rite Path policies and procedures.19. Assists with the correction of deficiencies and quality improvement efforts.20. Attends and participates in all required meetings.21. Commits to attending all training and staff development classes in order to ensure sufficient hours of training on anannual basis. Notifies supervisor if annual training hours are deficient.22. Other duties as assigned, verbally or in written form to meet the needs of the program.
High school diploma, BA/BS preferred.2. At least two years of experience in billing Medicaid/Medicare, Medicaid Managed Care plans, and/or CommercialInsurance. Certified Professional Biller preferred.3. Experience with patient billing, EMR systems and credentialing.4. Ability to pass a criminal background clearance check and obtain Arizona Fingerprint clearance card.5. Submit to drug screening, physical and TB test.6. Regular attendance is essential.
Ability to accept and adapt to changes in assignments, methods, environments, and policies.8. Ability to perform work with little or no supervision.9. Ability to utilize resources available to complete assigned projects.10. Ability to prepare written reports and correspondence (in English).11. Ability to understand and follow verbal and written instructions (in English).12. Ability to effectively communicate, verbally and in writing (in English).13. Must be able to maintain a high level of confidentiality.14. Must have excellent organization and time management skills.15. Ability to build and maintain positive internal and external relationships.16. Ability to provide exemplary customer service to all employees and outside constituents.17. Proficient in the use of computers and associated software.
Rite of Passage is a leading national provider of programs and opportunities for troubled and at-risk youth from social services, welfare agencies and juvenile courts. For 35 years, we have developed and operated a continuum of programs based on the needs of youth and our placing agencies. With an emphasis on evidence-based practices and positive skill development, combined with our supportive and therapeutic approach, our organization is respected by industry experts as a highly effective solution for our youth. Since 1984, over 25,000 youths have entered and completed our programs. Rite of Passage has built its reputation on running life-changing educational treatment programs that positively contribute to the community.
Our employees are dedicated, passionate individuals that are committed to inspiring positive change in the lives of youth. Becoming a member of the Rite of Passage team is more than just a job, it’s an opportunity to build a meaningful career with a company driven by its powerful mission to make a difference.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)