Behavioral Health Billing Specialist

Fair Haven Community Health Care 

FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at over 143,000 office visits in 21 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services, as well as evidence-based patient programs to educate patients in healthy lifestyle choices. As we grow and are able to bring high-quality health care to more areas that need access, we continue to put our patients first in everything we do. The mission of FHCHC is “To improve the health and social well-being of the communities we serve through equitable, high quality, patient-centered care that is culturally responsive.”

For 53 years, we have been a health care leader in our community focused on providing excellent, affordable primary care to all patients, regardless of insurance status or ability to pay. Fair Haven is proud to have a diverse and motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients. We believe that everyone should have access to high-quality medical and dental care, regardless of ability to pay.

Job purpose

Fair Haven prides itself on efficient billing services including the filing of claims, appeals processing, and authorizations and, above all, a great passion for helping individuals obtain treatment. The Behavior Health Billing Specialist works with the Billing and Behavior Health departments ensuring all claims are reviewed for accurate documentation, submission and reimbursement

Duties and responsibilities

The Behavior Health Billing Specialist maintains the professional reimbursement and collections process for the Behavior Health Program. Typical duties include but are not limited to:

• Reviews medical record documentation to determine appropriate ICD-10-CM/CPT codes and modifiers in accordance with official coding guidelines.
• Codes in accordance with coding and departmental guidelines. Maintaining no less than 93% accuracy in choice of codes, as observed in quarterly auditing.
• Prepares by review the submission of clean claims to various insurance companies including but not limited to; carrier, guarantor, place of service and servicing provider
• Works claims and claim denials to ensure maximum reimbursement for services provided
• Uses department resources regularly and follows workflows, with minimal assistance or intervention, to perform daily work to meet daily metrics.
• Works with peers and/or leadership to create and maintain accurate up-to-date policies and procedures.
• Perform other related duties that may be inclusive, but not listed on the job description

Qualifications

• Minimum of a High School Diploma or GED and 1 to 2 year of experience in a medical/behavioral setting.  The ideal candidate must have 1-2 years of Behavior Health billing and documentation review experience.
•  Previous leadership experience and a Certified Professional Coding (CPC) certificate through AAPC or other national recognized agency or willingness to obtain is preferred.   Experience in a Federally Qualified Health Center and being bilingual in English and Spanish is highly desirable.
• The selected candidate will have the ability to work in a team environment or independently; to meet all established deadlines, metrics and assignment goals; have oral and written proficiency in English and proficiency with computer applications and multi-lined telephones.

American with Disabilities Requirements:

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.

Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.