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Credentialing and Medical Billing Support Specialist

Company: Mental Health Resources Inc
Location: Saint Paul
Posted on: April 6, 2021

Job Description:

Full Time Saint Paul, MN, USMental Health Resources, Inc.

Mental Health Resources (MHR), Inc. is a progressive, nonprofit organization that offers community-based mental health and substance use disorder services to adults recovering from serious mental illness and/or substance use disorder.

See what employees have to say about working at MHR!



Mental Health Resources, Inc. is an Equal Employment Opportunity/Affirmative Action employer. We embrace diversity, inclusion, and employees who reflect the population we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

CREDENTIALING AND MEDICAL BILLING SUPPORT SPECIALIST

Saint Paul Office

$20.07/hr starting pay increased based on education/experience.

The Credentialing and Medical Billing Support Specialist is responsible for credentialing individual providers with health plans, and for assisting with facility credentialing as assigned. This position also problem-solves assigned aging claims for payment, provides back-up for other billing specialists as needed, and contacts people served to collect payment. The Credentialing and Billing Support Specialist is responsible for providing billing and service-related reports to assist managers with their fiscal management responsibilities and ensure compliance. This position requires an understanding of the organization's electronic medical record as well as medical billing processes.

Main Duties & Responsibilities:

  • Prepare and submit billing-related reports from the electronic medical record; ensure data integrity and on-time delivery to all users
  • Collaborate with billing, accounting, Continuous Quality Improvement (CQI) and compliance staff, and with program managers and directors, to provide all needed billing-related data
  • Evaluate reports to identify ways to improve their format and utility to managers
  • Maintain skills and expertise to use the most efficient technology to meet management's information needs
  • Maintain accurate records of NPI numbers and credentialing information for the agency and individual provider
  • Prepare and submit credentialing applications for individual providers to ensure ability to bill in-network for services; communicate with service providers throughout the process as needed
  • As assigned, assist with preparing and submitting agency provider enrollment applications to DHS, and preparing and submitting facility credentialing applications to health plans
  • Coordinate with the billing configuration specialist and other billing staff to ensure that accurate NPI and credentialed provider information is in the electronic medical record
  • Coordinate with the Human Resources department to track all newly licensed staff, and newly hired or contracted licensed staff, so credentialing applications are completed in a timely manner
  • Back-up billing as assigned:
  • Verify insurance for persons served in MN-ITS and payer websites; ensure that insurance information is accurate and updated in the electronic medical record
  • Prepare and submit electronic billing using the EMR and clearinghouse software, and prepare related billing and service reports
  • Retrieve and reconcile remittance advices from payer websites and clearinghouse. Apply payments in the EMR
  • As assigned, problem solve and follow up with insurance companies to collect payment on unpaid claims
  • Contact persons served as needed to collect payment on patient responsibility amounts; notify the billing manager of accounts to refer to collections
  • Maintain knowledge of and follow policies and procedures to maintain compliance
  • Maintain up-to-date knowledge of payer policies and applicable regulations and policies

    Minimum Education and Experience:
    • Associate's degree in medical billing, business administration or a closely related field and one year of closely related administrative experience OR high school diploma /GED and two years of closely related administrative experience
    • One year of credentialing experience required
    • Excel skills required, with intermediate level skills preferred
    • Experience in a mental health or SUD setting is strongly preferred
      Benefits Offered by MHR:
      • Intensive two-week initial orientation program AND on-going in-house training program
      • iPhone, laptop computer, and Wi-Fi provided for all community-based staff
      • Health insurance (including family health coverage) with employee costs in the top 6% of most affordable health care options. Competitive dental insurance
      • Automatic enrollment in retirement plan after 1 year with up to 4.5% employer contribution
      • 9 paid holidays and 18 days accrued PTO during your first year
      • Annual merit-based salary increase
      • Schedule primarily Monday-Friday during regular business hours
      • MHR is committed to working towards racial equity and combating racism
      • MHR is a tobacco free workplace promoting health & wellness for the individuals we serve and our employees

        PM19 PI133336298

Keywords: Mental Health Resources Inc, St. Paul , Credentialing and Medical Billing Support Specialist, Healthcare , Saint Paul, Minnesota

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