Billing Specialist - Part Time

Essential Duties and Responsibilities

• Provide comprehensive administrative support to the Vice President of Clinical Services and the Accounting Manager/Finance Department.
• Ensure compliance with North Carolina licensing statutes, regulations, and contractual LME/MCO policies.
• Collect and analyze program data, with a specific focus on authorizations and re-authorizations.
• Address billing inquiries, verify patient coverage, and monitor the status of authorizations and claims.
• Collaborate with clinical staff and the Finance Department to compile necessary documentation, promptly correcting and resubmitting denied claims within a 72-hour timeframe.
• Prepare and submit initial enrollments, target populations, and all documents required for initial authorizations with all MCOs including Alliance, Partners, VAYA.
• Act as the Liaison between Primary Counselor and MCO when additional information is requested.
• Respond to ALL denial emails that are received from MCOs including Alliance, Partners, VAYA.
• Facilitate admission and discharge processes, as well as service planning and service plan reviews.
• Conduct quality assurance reviews to ensure compliance with licensing and contractual obligations.
• Adhere to all HIPPA and confidentiality rules and guidelines.
• Perform additional duties as assigned by the Vice President of Clinical Services within the scope of the position.
• Actively engage as a member of the Hope Haven Clinical Team.
• Attend all required organizational meetings.

Position Qualifications

• Average or bachelor’s degree in the Human Services Field or related discipline with a minimum of one (1) year of related experience preferred.
• Proficient in Microsoft Office Suite, with an ability to learn additional reporting software as required.
• Ability to work effectively with a diverse, underserved population.

Physical Requirements

• Keyboarding
• Walking/Sitting
• Lifting