RI International is the leader in Peer-Powered Support to those in crisis for mental health and substance use.

Our Mission is to empower people to recover, succeed in accomplishing their goals, find meaning and purpose in life, and reconnect with themselves and others.

Our Vision is to activate the next generation of frame-breaking healthcare innovation to support people beyond their behavioral health needs and succeed in the community where they live, work, and play.

Job Type

Full-Time: Non-Exempt

Shift

Day

Shift Hours

8:00am to 5:00pm Monday-Friday

Specialties / Licenses or Certifications

N/A

Work Setting

Remote

Salary/Hourly Wage

$28.00 - $30.00/hour

Our Position

The Revenue Cycle Biller III position is responsible for providing claim processing, data entry and administrative support functions for the organization's Billing Department.

Your Responsibilities

• Experienced in end-to-end Revenue Cycle Management activities which includes initial claims submissions to primary, secondary, and tertiary funders, claims editing and scrubbing, and identifying the proper coding guidelines.
• Run reports from the practice management system daily to capture all charges to bill funders in a timely manner.
• Review rejections per funder upon processing of the CSV/835 file and follow up in the practice management system to fix errors for claims initial and resubmissions.
• Analyze electronic files, review, and update replacement codes and make the necessary corrections for accuracy per initial billing.
• Train, mentor, and educate new hires and monitor workflow on a daily basis for all states
• Identify and research rejections and follow up into the practice management system to ensure clean claims for initial submission of all claims.
• Ability to follow up on rejection via payer portals, edit, modify, and correct errors in the Practice Management system during your daily tasks
• Expert knowledge of Medicare, Medicaid, Third Party regulations and billing guidelines for claims submissions
• Follow-ups on claim rebills both electronically and manually, as needed, and uses all technology available to produce clean claims rate.
• Performs special resubmissions for projects, claims corrections by utilizing the appropriate claims codes per the funder guidelines.
• Review claims that are not set up electronically to ensure the correct payer ID# is added in the system.
• Interprets claims processing reports and applies information to produce clean claims.
• Make changes to the clients' demographics, make modifications to correct the funders' claims address, CPT, HCPCS, and ICD-10 codes as necessary to process clean claims.
• Must have the ability to analyze coding and diagnoses to assure proper billing of claims to funders.
• Requests and attaches required clinical documentation in accordance with third party requirements.
• Tracks all claims upon submission per funder and reports the data via Excel and saves it on SharePoint daily.
• Prioritizes work to maximize turnaround time and have a proven track record for improving process efficiencies and solving problems.
• Refer to the billing process to submit claims to all funders per state requirements.
• Understands and adheres to RI International compliance standards as they appear in the Code of Conduct and Conflict of Interest Policies.
• Performs other related duties as assigned.

Our Requirements

• High school diploma or equivalent.
• 5 years of medical billing experience.
• Working knowledge of CMS guidelines, contracted insurance guidelines and coding policies.
• Demonstrated computer skills.
• Detailed oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment.
• Intermediate to Advanced proficiency in Microsoft Excel.
• Ability to maintain a high level of confidentiality (HIPAA guidelines and regulations) and professionalism.
• Must have a valid driver license and be 18 years of age.
• Must have the ability to walk, climb, stoop, reach, crawl, crouch, kneel, push, pull and lift a minimum of 10lbs.
• Must have excellent written and verbal communication, with particular emphasis during telephone calls, follow-ups, and in-person correspondence.
• We are a Second-Chance Employer
• Must be able to pass a seven-year background check.
• Must be able to pass substance abuse testing and/or tuberculous testing (if applicable).
• Must be able to pass an education verification check.
• Must be able to pass a three-year motor vehicle report and meet minimum eligibility requirements criteria of insurance carrier (if driving is required for this position).

Associated Knowledge, Skills, and Abilities

• Above average computer skills including databases, spreadsheets, interface file maintenance and related computer programs designed for billing, coding, and accounting purposes.
• Ability to focus on the big picture while attending to multiple detail requirements in a changing environment.
• Ability to analyze and interpret data.
• Ability to formulate, recommend and implement solutions.
• Ability to adapt to change in the workplace and demonstrate the ability to work collectively within a diverse team environment.
• Ability to use critical thinking and reasoning skills to solve a problem.
• Ability to provide guidance and feedback to help others strengthen specific knowledge/skill areas.
• Ability to find a solution for or to deal proactively with work-related problems.

Working Environment

Work is performed in a typical interior office setting with moderate noise levels in addition to managing multiple projects at one time that may be interrupted frequently to meet the needs and requests of team members, customers, and management or C-level team members.

Working Conditions/Physical Requirements

Physical activities include typing, talking, and hearing in a sedentary work environment. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading; visual inspection involving small defects, small parts, and/or fabrication parts at distances close to the eyes.

Equipment or Machines Routinely Used in This Position

Required to use keyboard, mouse, and other electronic accessories in addition to fax machines, monitors, computers, laptops, mobile devices, tablets, presentations remotes, televisions, printers, scanners, postage meter, multi-line phone, headset or Bluetooth related devices.

Review Procedures

A regular review and evaluation of the employee's work performance will be conducted.

RI International is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran status, race, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable laws, regulations, and ordinances. RI International is a second chance employer and we consider qualified applicants regardless of criminal histories, consistent with legal requirements. If you need assistance and/or reasonable accommodation due to a disability during the application or the recruiting process, please send a request via the Accommodation request form.

Benefits/perks listed above may vary depending on the nature of your employment with RI International.

The wage range for this role considers the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. At RI International, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case.