About the Role

The purpose of this position is to ensure patient accounts are accurately reflected according to proper claims accounting when reviewing credit balances due to either the patient or the insurance payer. Given the complexities of the insurance contracts and patient financial records, it is vital we have strong, analytical, customer focus driven individuals in this role.

Our team is comprised of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. We are looking for a candidate who is inspired by our mission and excited by the opportunity to increase access to mental healthcare and impact millions of lives in a profound way.

Responsibilities

• Review and research patient accounts with credit balances. Contact insurance payers and patients to help determine resolution. Evaluate documentation for posting or payment discrepancies. Initiate a refund or validate a corrected claim using billing software based on payer regulations and departmental policies and procedures. Recognizes and reports trends and potential problems with billing and posting issues that create credit balances. Documents all actions taken
• Validate all requests from insurance payers for a refund, ensuring they are legitimate in accordance with our contractual obligations. Initiate a refund within the required timeframe. Documents all actions taken
• Reviews payer bulletins and websites for changes in rules and regulations. Corresponds with the Billing team and Commercial Strategy on any updates from bulletins and/or websites.
• Responds to all refund requests for timely claim resolution and prompt patient customer service
• Performs in accordance with accepted procedure and responds to special requests by management in a timely and accurate manner
• Adheres to the policies and procedures. Uses tact and courtesy in all interactions including but not limited to staff, patients, and payers. Promotes a positive image and supports management in goals and objectives. Handles inquiries and complaints discreetly and effectively

Requirements

• 3 years of payer refund experience, preferably in behavioral health
• Knowledge of payer specific requirements
• Experience in navigating payer websites
• Highly organized and able to track workflows through various tools
• Proficiency with medical record technology required
• Proficiency in Microsoft office required
• Knowledge of medical billing practices, office policies and procedures
• Knowledge of all confidential requirements regarding patients and strict maintenance of proper confidentiality on all such information
• Excellent written and verbal communication skills 
• Strict attention to details 
• Able to work a hybrid schedule of 4 days per week in our Nashville office and located within 75 minutes' commuting distance of the office

Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.

Additional Information

Note: We are not currently considering applicants in CA, CO, NY, and WA for this position. #LI-HYBRID