Medical Billing Specialist

The Medical Billing Specialist will bill clinic and behavioral health patients, their insurances, etc., to ensure payments are received for services rendered. This role will work in the Revenue Cycle team of the Fiscal Department, alongside the credentialing team and other clinic support administrative staff. 

Essential Duties

• Review electronic work queues and reports to assess coding and charting accuracy.
• Record and post insurance payments in deposit log and Credible BH Software.
• Manage and maintain Assertive Community Treatment (ACT), MH/SUD authorizations, and verify corresponding patient insurance.
• Manage and maintain Multnomah Other and Multnomah Treatment Fund coverage and authorizations for uninsured MH/SUD clients.
• Work with medical, mental health, and other staff to insure accurate charting for billing.
• Work closely with Fiscal Department to ensure accurate payment records.
• Submits paper and electronic claim files on a weekly basis to claims clearinghouse.
• Research claim denials, aging reports and take such steps as necessary to guarantee payment of claims.
• Work directly with Multnomah County, Tri-Counties (Multnomah, Washington, Clackamas) and Health Share Pathways to ensure accurate billing and reporting processes.
• Work with Data and Reporting Specialist to maintain Credible BH Software billing matrix, trouble-shoot billing, charting and reporting issues.
• Review, process and scan Self-Attestation forms and Hardship Fee Waivers to patient registration for clinic.
• Review and process dental charges in patient registration for clinic.
• Administer provider portals for employee use to verify eligibility, check claim status or print remittance advices.
• Work collaboratively with OCHIN Billing Service to ensure that insurance payments have been batched correctly and timely.
• Contribute to department and organization special projects as assigned.

Knowledge and Skills

Knowledge

• Knowledge of current medical billing best practices
• Knowledge of accounting best practices with respect to AP and revenue, as well as it’s impact on the agency

Skills

• Accurate and timely data processing
• Strong communication skills, both verbal and written

Education / Experience

• Proof of COVID-19 vaccination status or approved medical or religious exception on file is required.
• Medical billing certificate or diploma helpful.
• Billing experience, including Medicare and Medicaid, Mental Health, Alcohol & Drug, and FQHC billing experience preferred.
• Familiarity with electronic medical records, experience with OCHIN and Credible a plus.
• Experience with chart reviews and coding.
• Capable of working independently and collaboratively.
• Well-organized and detail-oriented.
• Good communication skills.

Working Conditions

This job includes working in standard office environment.

Physical Requirements

While performing the duties of this job, the employee is regularly required to sit and talk or hear for extended periods. The employee frequently is required to use hands and fingers to type, answer phones and forward calls. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 20 pounds.

Working at Outside In brings with it a sense of accomplishment and pride in being part of a mission that impacts people’s lives. In recognition to those that are a part of this agency, Outside In offers the following benefits to its employees.

• Medical Insurance through Kaiser Permanente. Outside In pays 100% of the premium for employee-only coverage, 75% for employee+children, and 66% for employee+spouse or family.
• Dental Insurance administered through Moda with plans starting at no cost to employees.
• Life Insurance ($50, 000) and AD&D insurance – premiums fully paid by Outside In for employee
• 403(b) retirement plan through Valic. Employees can contribute on day one and are fully vested. Employer contribution begins after meeting minimum time in service and hours worked requirements, 3% the first year of participation, 6% thereafter.
• Short Term and Long Term Disability Insurance fully paid for by the employer. We hope you never have to use it, but it’s nice to know it’s there if you need it.
• A generous Paid Time Off package starting with 21 days PTO in the first year increases every year until year 6.
• Holidays – 13 of them each year
• Flex Plans – We have three plans: Health, Dependent Care, and Transportation to save you some money on taxes. In fact, to make it even better, Outside In deposits $1500 annually into a HRA to help cover your out-of-pocket costs.
• Employee Assistant Program (EAP) is there to help you through life’s journey. From counseling to help finding what you need, it’s all there and better yet, it’s free for employees.
• Employee Discount Program – Employees can go online and take advantage of employer discounts on everything from dining to cars.