Claims Analyst
Are you an organized and detail-oriented individual who has medical billing or collections experience? Then come join our Billing team as a Claims Analyst.
Claims Analysts at Behavioral Health Network are responsible for performing all duties to improve the efficiency, quality, and financial outcomes of the revenue cycle.
This includes tasks that ensure timely payment integrity, forecasting of expected revenue, reconciliation of forecasted earnings with payment receipts, reporting, claims processing, escalation, and project management.
Claims Analysts are also responsible for correctly coordinating the format of Electronic Data Interchange (EDI) files.
Interact with insurance companies to ensure that BHN claims are processed to meet the guidelines established by the contract.
Act as a liaison between the billing department, program, vendors, and provider representative, looking to establish and maintain relationships to improve the claims process. Payment Integrity Claims Analysts assist in the cross training of staff on responsibilities required by management.
Who are we?
Behavioral Health Network is a growing non-profit community behavioral health agency that has been providing services to children, adults, families and communities in Western Massachusetts since 1938. BHN provides comprehensive, outcome-driven behavioral health care. We are dedicated to offering high quality, affordable and culturally appropriate care to people of all ages and income levels in our constituent communities.
Reasons to work with BHN:
- Work with an agency who does amazing things for others
- You will be able to change a person’s life
- You will expand your experience in various areas of mental & behavioral health
- You will have the opportunity to grow within the agency
- You will not be bored with our fast-paced environment
- You will have excellent benefits package & time off benefits available
Job Requirements:
Payment Integrity Claims Analysts at Behavioral Health Network have the following qualities:
- Associate degree or equivalent (coding certification) required.
- At least five (5) years overall revenue cycle experience.
- Minimum of two (2) years of analytical skills.
- Ability to manage multiple concurrent activities
- Ability to either use or learn computer applications as applicable to the role: (Carelogic, Ability, Excel, VLOOKUPs, pivot tables etc)
- Ability to schedule, meet, and maintain daily and monthly routines, as well as preserve the integrity of the EHR.
- Must have strong knowledge of (Behavioral Health and Substance Use Disorder) medical insurance billing and collections with CPT, ICD10, and HCPC coding and medical terminology, as well as an overall understating of managed care products (HMO, PPO, etc.).
- Must possess excellent analytic and problem-solving skills.
- Extensive knowledge of behavioral health and substance use disorder billing and reimbursement process.
- Ability to become proficient on all processes surrounding adjudication of Behavioral Health and Substance Use Disorder claims and member eligibility.
- Strong team player
- Remote work from home opportunity.
- Ability to accept responsibility for medium to large scale projects involving multiple resources and spanning many months from start to finish.
- Ability to communicate root cause and recommendations to Management and direct and implement solutions
- **NOTICE**
- In accordance with the BHN Mandatory COVID vaccine policy - all staff, interns, temps, residents and contractors are required to be fully vaccinated no later than day one of employment. Medical or religious exemptions will be offered and must be approved prior to starting work.
- The same guidelines noted above apply during flu season (defined as December 1st – through end of flu season as announced by the CDC) for BHN’s Mandatory Influenza Vaccine policy.
- Additionally, BHN is a Tobacco Free workplace. All Staff, interns, temps, residents and contractors agree not to smell of or use Tobacco or ENDS products while on paid work time or within sight of any BHN facility.
If you are interested in this opportunity, please visit our website at www.bhnworks.org and click on “Browse All Jobs” to apply!
BHN maintains its commitment to social justice and diversity and strongly encourages diverse candidates to apply.
Behavioral Health Network
Springfield, MA