Billing Specialist - Part Time

JOB SUMMARY

The Billing Specialistis responsible for submitting authorization requests and enrollment forms toinsurance providers, ensuring timely and accurate processing of claims. The specialistwill also manage billing inquiries, verify patient insurance coverage, andtrack the status of authorizations and claims. Additionally, the role involvescollaborating with clinical staff to gather necessary documentation, correctingand resubmitting any denied claims, and maintaining compliance with allrelevant regulatory requirements. The Billing Specialist contributes to thefacility's financial health by optimizing revenue cycle processes andsupporting the delivery of high-quality care to clients.

ESSENTIAL DUTIES ANDRESPONSIBILITIES :

§ Providecomprehensive administrative support to the Vice President of Clinical Servicesand the Accounting Manager / Finance Department.

§ Ensurecompliance with North Carolina licensing statutes, regulations, and contractualLME / MCO policies.

§ Collectand analyze program data, with a specific focus on authorizations andre-authorizations.

§ Addressbilling inquiries, verify patient coverage, and monitor the status ofauthorizations and claims.

§ Collaboratewith clinical staff and the Finance Department to compile necessarydocumentation, promptly correcting and resubmitting denied claims within a72-hour timeframe.

§ Preparation andsubmission of initial enrollments, target populations, and all documentsrequired for initial authorizations with all MCOs including Alliance, Partners,VAYA

§ Act as the Liaisonbetween Primary Counselor and MCO when additional information is requested

§ Respondto ALL denial emails that are received from MCOs including Alliance, Partners,VAYA

§ Facilitateadmission and discharge processes, as well as service planning and service planreviews

§ Conductquality assurance reviews to ensure compliance with licensing and contractualobligations

§ Adhereto all HIPPA and confidentiality rules and guidelines

§ Performadditional duties as assigned by the Vice President of Clinical Services withinthe scope of the position

§ Activelyengage as a member of the Hope Haven Clinical Team

§ Attending all required organizationalmeetings.

POSITION QUALIFICATIONS :

§ Associate orbachelor's degree in the Human Services Field or related discipline with aminimum of one (1) year of related experience preferred.

§ Proficientin Microsoft Office Suite, with an ability to learn additional reportingsoftware as required.

§ Ability to workeffectively with a diverse, underserved population.

PHYSICALREQUIREMENTS :

• Keyboarding
• Walking / Sitting
• Lifting

Hope Haven, Inc. is an EEO Employer - M / F / Disability / Protected Veteran Status