Company Overview:

On Demand Counseling is Ohio’s top provider of medication assisted treatment services (MAT) for those working toward recovery from opioid or alcohol misuse. We offer a variety of services including one-on-one counseling, telehealth, group therapy, and supportive services. Our team is passionate about addiction treatment and supporting patients through their journey to recovery.

Position Overview:

Our Credentialing and Billing Specialist submits and advances claims through the insurance billing process. They address insurance billing issues and respond to various requests from insurance companies. They also gather, track, and complete new and renewal credentialing applications with Medicare, Medicaid, and commercial insurance. 

Responsibilities:

• Responsible for gathering, tracking, and completing new and re-credentialing applications with Medicare, Medicaid, and Commercial Insurances.
• Experience with PECOS, PNM, CAQH websites
• Update providers CAQH as needed.
• Follows the Network Management workflow process in real time meeting required turnaround times and accuracy rates.
• Facilitates research and resolves denied claims & enrollment issues
• Review and submit claims based on payer guidelines and within the filing time limits.
• Obtain updated or missing claim information from physicians and/or patients.
• Complete assigned claim and follow-up worklist tasks.
• Provide insurance companies with the descriptions, results, medical records, tax information, and licenses when requested.
• Call insurance companies to determine the status of claims submitted.
• Comply with all Billing and Follow-up worklist process, system, and documentation SOPs.
• Meet claim filing and follow-up deadlines by completing assigned worklist tasks in a timely manner and/or reporting to management when assistance is needed to complete the tasks.
• Report all changes to insurance company claim processing requirements to the Billing Manager.
• Participate in team meetings by sharing the details of cases worked.
• Other duties as assigned.

Qualifications:

• High School diploma or GED
• Experience with Ohio BWC credentialing and billing process. i.e. Medco forms, C9,C86, and C23 forms.
• Familiar with Worker's Compensation billing
• Minimum of two years health insurance billing experience
• Detail oriented and ability to multi-task
• Ability to maintain confidentiality
• Possess excellent written and verbal communication skills
• Ability to establish priorities, work independently, and proceed with objectives without supervision.
• Proficient in using Microsoft Excel and Word
• Knowledge of KIPU billing software is a plus

Benefits:

• 80% company-paid base health insurance for the employee & dependents effective the first of the month following your start date.
• Optional dental and vision plans at reduced rates.
• Optional Short-Term Disability
• 100% company paid life insurance plan of $25,000 (with supplemental available).
• 401(k) with above average matching after one year of employment.
• Paid Time Off (PTO) begins accruing immediately upon first day of work.
• 6 paid holidays.

Physical Demands:

Physical demands described are representative of those that must be routinely met by an employee to successfully perform the essential duties of this position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

• Ability to lift up to 25 pounds.
• Ability to perform job responsibilities in a facility with multiple levels and without elevator or mechanical transportation.