The Revenue Cycle Billing Specialist assists in managing charge data from a network of over 90+ providers that subcontract with The Behavioral Health Provider Network (BHPN) to provide behavioral health and therapy services for families. In addition, the Revenue Cycle Billing Specialist assists in facilitating necessary steps to streamline the charge processing methods for payment to vendors and submission of claims to insurance carriers. This method includes building interdepartmental communication and validating all incoming charge data to be processed accordingly. The Specialist will be responsible for compiling billing information, ensuring all charges are entered accurately in timely manner and functioning as a champion of client billing and administration.
ESSENTIAL JOB FUNCTIONS
Serve as a liaison between BHPN vendors, BHPN Operations department, and Catalight Finance teams to facilitate the processing of claims.
Receive and review charge documents for accuracy and coordinate with providers on payment/billing issues.
Support BHPN vendors on charge processing/payment inquiries by serving as the primary point of contact for assigned vendors.
Ensure data integrity by monitoring the validation charge processing in the Salesforce platform.
Utilize the Salesforce, Athena EHR, and reporting functions as required to create valid claims, provide accurate payment information and analyze exceptions.
Review and analyze unexpected data outcomes and work cross functionally to find solutions.
Perform data manipulation and reporting in Excel as required to provide claim corrections, monitor process flow and answer inquiries.
Develop positive working relationships with all members of Catalight and the BHPN teams.
Complete additional job duties as assigned by Manager.
QUALIFICATIONS
Minimum Education, Experience & Training Equivalent to:
High School degree or GED required.
Bachelor's degree preferred.
Revenue Cycle, Charge Entry, or Healthcare Billing experience preferred.
Salesforce, Athena, or JIRA experience preferred.
Knowledge, Skills & Abilities:
Sensitivity to working with an ethnically, linguistically, culturally, and economically diverse population.
A commitment to the values of the organization while demonstrating good judgment, flexibility, patience and discretion when dealing with confidential and sensitive matters.
Proficient in Microsoft Office (Outlook, Word, Excel, etc.), especially Excel and related computer software.
Ability to consistently demonstrate good judgment and decision-making skills.
Ability to maintain the highest levels of confidentiality.
Ability to work in an exciting, fast paced high energy environment while effectively multitasking.
Personable; able to work comfortably with individuals at all levels within the organization.
Ability to manage day-to-day responsibilities without supervision.
Frequent proofreading and checking documents for accuracy.
Excellent verbal and written communication skills.
Must be highly detail-oriented.
Strong interpersonal skills.
Physical Requirements:
Must be able to communicate effectively within the work environment, read and write using the primary language with the workplace.
Visual and auditory ability to work with clients, staff and others in the workplace continuously.
Frequent speaking and listening (25-75%) to clients, staff, and others in the workplace.
Ability to utilize computer, cell phone (iPhone), fax machine, telephone and copy machine.
Frequent sitting.
CONDITIONS OF EMPLOYMENT
Ability to obtain and maintain criminal record clearance through the Department of Justice (DOJ). The People & Performance Department must analyze DOJ/FBI live scan reports in accordance with applicable Federal, State, and Local laws, as well as fitness for the position.
Must be able to pass credit check
Ability to obtain and maintain clearance through the Office of Inspector General.
Must attend any required training.
About Us
Catalight is a new foundation that helps home and community-based organizations transform their business operations, so they can focus on growing and scaling efficiently. Catalight provides customers with strategic solutions, support and financial access, allowing them to breakdown internal barriers and expand their impact in the communities they serve.
Catalight is also the parent company in our family of companies where it provides executive oversight, strategic planning and shared services like finance, legal, compliance, human resources, business development, communications, and clinical optimization.
The family of companies is a strategic set of non-profit organizations, including Easterseals Northern California, Easterseals Hawaii, the Behavioral Health Provider Network (BHPN), and Xolv, that are working together to responsibly disrupt and transform the delivery of home and community-based care.