RCM Billing Specialist | Inpatient

Location

Federal Way Administration, WA

705

0

As a non‑profit organization, Valley Cities Behavioral Health Care is dedicated to serving our community by offering a wide range of mental health services, from inpatient to outpatient care. We believe that our employees are our greatest asset and we are committed to creating a supportive and inclusive work environment. Join us in making a difference every day!

This position is responsible for billing services. Ensure that claims are billed correctly and in a timely way. Ensure unpaid claims are researched promptly. Also serves as back up to other administrative support positions.

• Assist RCM Manager with monitoring and reporting on and facilitating correction of data input errors on a daily basis to ensure benefits remain active without interruption of revenue.
• Content and performance expert on all payor billing requirements, train Revenue Cycle, Clinical and Facilities staff as needed on all those requirements as they relate to their responsibilities.
• Support RCM Manager by working collaboratively with Valley Cities utilization management staff to ensure authorizations and concurrent review authorization extensions are completed timely and accurately and recorded in the electronic health record and billing system.
• Monitor and audit bed board assignments, episode of care, and other data requirements for accurate billing of inpatient per diem and room and board charges.
• Ensure communication regarding King County census status is verified and applied correctly to inpatient services for data upload of services to King County as required by contract.
• Create inpatient services in billing system and submit electronic claims via payor portals, clearinghouse, King County systems and any other methods as necessary.
• Train on and facilitate the resolution of clearinghouse rejections on all claims daily.
• Follow‑up on inpatient and outpatient claims that remain unpaid beyond each specific payor’s expected turn‑around times to ensure timely reimbursement.
• Reinforce RCM Manager’s directives by monitoring claim payments and performing denial management of all inpatient and outpatient claims daily ensuring all denials received in a specific month are acted upon prior to that month’s accounting close date.
• Accurately and efficiently post all inpatient per diem and room and board claim payments daily.
• Monitor and report on root cause analysis of denied claims and develop and train other RCM Specialists on process improvement measures to reduce denials.
• Identify and resolve accounts receivable inpatient aging issues to ensure agency’s policy and requirements are met.
• Perform data entry from source documents into the Electronic Health Record (EHR) for client services being billed or otherwise reported to commercial third party, contract, State of Washington, and King County payors.
• Collaborate with RCM Manager as content and process experts for all King County, commercial and other third‑party billing and claim resolution.
• Assist clients and staff with billing related questions.
• Provide support to RCM Manager in training revenue cycle, clinical and utilization management staff in procedures required to maximize reimbursement.
• Assist RCM Manager in the development and management of RCM Standard Operating Procedures (SOPs).
• Participate in Quality Management process, practice and incorporate Quality Improvement principles in daily work activities.
• Maintain strict confidentiality and security about clinical and financial information.
• Maintain required levels of productivity and performance standards.
• Meet all required work deadlines.
• Ensure RCM Manager receives proper and timely information that is relevant to agency business.
• Learn and follow all related JCAHO, Federal, State, local and Agency requirements and established agency Policies and Procedures.
• Attend required in‑service training and meetings.

• Attend Committee meetings as requested
• Perform other related duties as assigned.
• Attend VCCC meetings and travel to and from work‑related events as required.

Minimum Qualifications

• Associate…