Reimbursement Specialist

Position Specific Duties & Responsibilities

• Generate and complete assigned reports, adhering to established schedules and completion timelines, utilizing the electronic health record system, Report Manager, and PICIS.
• Ensure accuracy of data submitted to guarantors and state agencies, by reviewing, verifying, and updating client information in electronic health record system, including demographics, financial eligibility, services, diagnoses, and authorizations.
• Communicate and collaborate with other agency staff and outside entities, in order to correct errors, resolve issues, and provide assistance to staff both within the department and throughout the agency.
• Execute all assigned tasks, following departmental processes and procedures, and meeting all goals as set forth by the department.
• Review all clinicians daily billing reports to ensure accuracy.
• Make recommendations for updates, changes or process improvements in order to capture available billing in timely manner for program.

Qualifications

• EDUCATION: Must be a high school graduate or have HS equivalent
• Experience: Minimum of two years’ experience with Medicaid and ODMHSAS eligibility verification, billing, and authorizations within an outpatient behavioral health setting. Experience with Medicare and other third party billings is a plus.

Performance Competencies

• Generate and Deliver Reports
• Process and Procedures

Essential Behaviors

• Billing compliance and Accurancy

Safety Sensitivity

This job is classified as a “safety-sensitive” position as defined by the Oklahoma Medical Marijuana and Patient Protection Act. Due to the “safety-sensitive” classification, an employee in this position would be subject to drug and alcohol testing, including random testing. Marijuana is one of the substances included in the drug panel screening. Possession of a medical marijuana license will not excuse you from the testing process or the consequences of testing positive for marijuana per the Family & Children’s Services Drug Free Workplace Policy, including possible revocation of a job offer or dismissal from employment.