Veterans Affairs Billing Specialist

Vertava Health Nashville, TN
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ABOUT VERTAVA HEALTH: Vertava Health is a leading national behavioral healthcare system for mental health and substance use disorders, providing a full continuum of services based on the individuals' varying needs at different times in their health and recovery journey. We apply evidence-based treatment modalities at every level of care and embed digital health tools to enhance and amplify clinical outcomes. With a growing list of Joint Commission accredited inpatient and outpatient locations across the country, a virtual care platform and a national network of healthcare providers, Vertava Health pioneers care that empowers people so that they can live out their best future.

Please note that this is a remote position, but the ideal candidate will be available to come onsite to our Nashville office as needed.

Position Summary:

The VA Billing and Collections Specialist ensures financial procedures are completed for all clients billed to the Veterans Administration.  The Billing Specialist works with Business Development team and facility to retrieve all pertinent financial and demographic information.  They are responsible for providing financial posting services which may include entering receivables, printing and balancing data entered in to the system, performing basic computer system maintenance, preparing contracts, updating logs, and contacting vendors and payers.  In addition, the specialist ensures that the collection of payments from insurance is in a timely and accurate manner.  The Billing Specialist is in close contact with the U/R department, the Case Manager and Clinical teams at the facility and the Director of Admission Operations to ensure the patients financial concerns are addressed before the patient is admitted into the program.

Primary Responsibilities:

  • Provides data processing support to ensure proper and timely entry receivables within the deadlines given. 
  • Provides receivable processing support for the preparation of various facility reports and statistical reporting.
  • Prints and balances all daily and monthly receivable reports and updates files as directed by the Director of Admission Operations.
  • Ensures accounts receivable postings are current and accurate; makes adjustments as requested.
  • Inputs all charges, payments, and adjustments to patient accounts within an acceptable time frame of charge generation.
  • Ensures all batches are balanced within the appropriate time frame.
  • Provides support for admissions and new clients to the Facility- including insurance verification, financial counseling, prior authorizations.
  • Audit insurance verifications to ensure client accounts are accurate when presented to the third-party payers.
  • Provides communication for admissions to all pertinent staff at the Facility.
  • Submit claim corrections as applicable.

Note:  The essential job functions of this position are not limited to the duties listed above.

Qualifications:

  • Education: Degree in medical billing and coding is preferred.
  • Experience:   A minimum of two (2) years’ experience in a healthcare facility.  Behavioral Health experience is a plus.  Billing VA CCN claims through Optum and Triwest is preferred. 
  • Certification: Certified Coding Specialist preferred, Certified Coding Assistant with 2 years’ experience is acceptable.
  • Additional Requirements: A working knowledge of the DSM-V, ICD-10, CPT, Rev, HCPCS, and denial codes.

Knowledge, Skills, and Abilities:

  • Work effectively and efficiently in an independent role.
  • Ability to remain calm while working efficiently under stressful conditions.
  • Must have excellent interpersonal communication skills, to include written and verbal, in order to effectively communicate insurance benefits to the treatment team.
  • Ability to accurately read Explanations of Benefits from third-party payers.
  • Working knowledge of billing systems in identified electronic health record systems.
  • Knowledge of common forms used to submit claims to third-party payers: UBO4, CMS 1500.
  • Build and maintain relationships with designated representatives of third-party payers.

Physical Requirements:

  • Ability to sit, use hands and fingers, talk and hear continually. Ability to stand, walk and reach continually. Ability to climb or balance, stoop, kneel, or crouch frequently.
  • Ability to frequently lift and carry up to 20 lbs.
  • Close vision required to see computer monitor, read documents, and operate copy and fax machine.
  • Work environment is indoors and climate controlled. Occasionally exposed to outdoor weather conditions.
Vertava Health is an EEO employer - M/F/Vets/Disabled
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