Billing Quality Analyst

Billing Rockville, Maryland


Description

Description:

Credible Behavioral Health Software is a leading Behavioral Health Enterprise Software company based in Rockville, MD and providing an Electronic Health Record (EHR) to the growing US Behavioral Health market. Recognized by Deloitte as one of the 500 fastest growing companies in North America (see Deloitte Fast 500) and Inc. as one of the Top 50 Companies to work for, Credible is expanding Rockville, MD based team. For Credible, our Mission is paramount and central to our success:  Improving the quality of care and lives in behavioral health for clients, families and providers. If you are interested in combining a mission driven position with a fast paced, results oriented culture, please apply today.

Credible is looking for qualified candidates with experience in Behavioral Health Care Medical Billing. This position is responsible for working collaboratively with Partner agencies, Billing Specialists, and National Billing Manager to ensure accuracy in billing processes and procedures and reduction of errors.

Overall Position Responsibilities for Billing Quality Analyst:

  • Work collaboratively with Partner Agencies to determine billing inconsistencies, workflow discrepancies, and develop work plan for correction.
  • Work collaboratively with Billing Specialists to improve quality of billing procedures and documentation.
  • Work collaboratively with the National Billing Manager to improve internal processes and increase checks and balances to decrease risk of billing errors.

Success Defined for Billing Quality Analyst:

  • Audit Outsource Billing Contracts to ensure compliance with documentation standards.
  • Audit Outsource Billing Contracts to ensure compliance with Partner Agencies Work Plans.
  • Audit Outsource Billing Contracts to ensure compliance with Payer regulations.
  • Understand how to read and interpret EDI files.
  • Understand and consistently apply Credible’s Best Practice workflows for pre-billing, batching, and posting.
  • Maintains confidentiality; adheres to all HIPAA guidelines/regulations.
  • Learn and develop a thorough understanding of Credible software.
  • Complete Credible New Employee Orientation program.
  • Completion of Credible’s product knowledge and training.
  • Clear understanding of Credible’s:
    • Culture:
    • Corporate structure: and
    • Line of business
  • Other Duties as assigned by Supervisor.

Qualifications:

  • Previous medical billing experience along with knowledge of billing related reporting; 3 - 5 years’ experience in Behavioral health-care billing & collection practices
  • Experience in Quality Review/Auditing of Billing claims
  • Experience working with medical payers such as Medicare, Medicaid, commercial insurances
  • Working knowledge of medical billing systems/softwares
  • Experience with Medicaid’s State Eligibility Systems (various states)
  • Working knowledge of CPT and ICD-9/ICD-10 coding systems; Coding certification preferred
  • BA/BS preferred
  • Excellent organizational skills
  • Proficiency in Microsoft Office Suite

Credible is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law