Behavioral Health Insurance and Billing Specialist Job at Kodiak Area Native Association
The Kodiak Area Native Association (KANA) has been providing exceptional patient and family focused health care and social services to the people of Kodiak Island since 1966. KANA’s patient-centered medical home model incorporates Behavioral Health, Dental, and Pharmacy services within the primary care setting to facilitate an advanced support system that ensures our patients’ needs are met. KANA also offers Child Services and Youth Prevention programs; Women, Infant and Children (WIC); Vocational Rehabilitation; Employment and Training services; Early Childhood and Infant Learning, and a full service fitness center to support the whole person.
Kodiak Area Native Association (KANA) uses E-Verify to check the work authorization of all new hires effective January 2022. For more information about E-Verify, please see the following:
- E-Verify Poster (PDF)
- Right To Work Poster - English (PDF)
- Right To Work Poster - Spanish (PDF)
Provides oversight to all billing activity conducted through the Behavioral Health (BH) department. Works collaboratively with KANA staff, BH providers, third party billing and insurance companies, and patients to ensure accurate and current information is gathered and entered into the system in a timely manner to generate a clean bill and prompt reimbursement for all BH claims. Works closely with BH Compliance Specialist to ensure documentation meets criteria for successful billing.
Essential Duties and Responsibilities
- Support the organization’s mission and goals, quality standards, and patient-centered medical home philosophy. Embrace KANA’s culture of serving the whole person through our provision of services. Incorporate KANA’s core values of Courtesy, Caring, Respect, Sharing, and Pride in all activities and decisions.
- Uphold KANA’s Code of Ethics by conducting professional activities with honesty, integrity, respect, fairness, and good faith in a manner that reflects positively upon the organization.
Quality review, coding, billing submission for all Behavioral Health staff, including daily review of coding queue, feedback to staff on files that are not in compliance, oversight of documentation nearing 72-hour deadline; review and filing of signed treatment plans and consent for treatment.
Track missed billing encounters; work with BH Compliance Specialist to identify billing trends affecting department revenue; provide reports to Revenue Cycle Manager, BH Director, Associate BH Director, or designee with recommendations for areas of improvement.
Grant funded encounter tracking: Track all clients served under a grant that specifies “free care.” Records exemptions in CERNER, and communicates to appropriate personnel.
Coordinate service authorization process for providers, including tracking service limits, ensuring providers complete service authorizations, submitting service authorization requests, and tracking approvals and recording in medical record.
Manage information for psychiatry referrals - ensure referrals are electronically filed, request prior authorization, print/send records prior to appointments.
Oversight of all ISA billing activities and documentation through BH EHR software, to include checking client eligibility, QA and billing of all ISA notes, monthly review of transaction reports.
Attend meetings and training as requested, such as billing meetings, revenue meetings, QA team meetings, BH EHR User Groups, etc.
In coordination with the Revenue Cycle Manager and BH Director, communicates with partners at Optum Alaska, DBH, and other appropriate parties regarding technical questions and departmental needs.
Other duties as assigned.
This job has no supervisory responsibilities.
High school diploma or equivalent and one to two years related experience and/or training; or equivalent combination of education and experience. Bachelor’s degree in related field preferred. Background and/or training in medical billing, coding, and/or accounting is preferred. Knowledge of BH EHR billing and documentation practices, and an understanding of Alaska Behavioral Health regulations preferred. To perform this job successfully, an individual should have knowledge of Internet, Spreadsheet, and Word Processing software; and Electronic Health Records systems.
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