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Billing Specialist - Kalamazoo

Job Type: 
Full-Time
Department: 
Operations Dept. Kalamazoo
Description: 
  • Assist with implementation of agency tracking of insurance for persons served.

    Ensure services are completed and billed within funding source rules.

    Assist with implementation of agency billing systems including KCMHSAS, SWMBH, and Network 180, according to agency policy.

Responsibilities: 
  • Verify Medicaid and Medicare information for persons referred by KCMHSAS, SWMBH, and Network 180 using Streamline and insurance verification websites.
  • Monitor insurance verification and communicate changes/status of insurance with agency clinical staff to ensure continuity of insurance.
  • Complete Medicaid spenddown and timely reporting to Michigan Department of Health and Human Services (MDHHS).
  • Complete and submit Ability to Pay (ATP) Payment Agreement at referral, when insurance changes, and annually. Ensure data is accurate and updated in InterAct’s and funders’ EHR to meet contract requirements.
  • Complete and submit the Level of Care form to MDHHS and SSA for individuals with entitlement benefits when their residency status changes.
  • Monitor service errors and resolve issues prior to billing deadlines.
  • Ensure accurate authorizations are entered into InterAct’s EHR in a timely manner; troubleshoot issues and submit appeals when appropriate
  • Communicate effectively with clinical staff as necessary to meet standards.

Requirements: 

Minimum Requirements:  

    • High School diploma or equivalent required; Minimum of two years’ college strongly preferred.
    • Excellent organizational ability, attention to details, analytical skills and high degree of accuracy essential.
    • Effective communication and negotiation, and problem-solving skills required.
    • Previous experience working in medical, mental health or human services field required.

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