ABH REIMBURSEMENT COORDINATOR

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Description/Job Summary



This position is responsible for ensuring behavioral health claims are uploaded accurately and timely in the electronic claims processing system and are in compliance with State, Federal, Contractual and Agency standards. This position is responsible for verifying member eligibility, benefits limits and authorizations, as well as, ensuring standard billing practices are met in order to adjudicate a claim. The Access Behavioral Health (ABH) Reimbursement Coordinator is responsible for ensuring accurate explanations of benefits are sent to providers. This position is also required to develop and maintain strong working relationships with providers and respond to claims inquiries over the phone, fax, and mail. The Reimbursement Coordinator is responsible for responding to audits within the specified timeframe given by the manager.




Assignments/tasks are expected to be executed with considerable independence and maintain compliance with established facility policies and procedures, contract requirements, organization bylaws, and federal and state regulations/laws.



Required Skills


  • Associate (AA) degree.
  • Three (3) years relevant medical office experience.
  • High school diploma or GED with five (5) years related experience may be substituted.
  • Thorough understanding of Florida Medicaid regulations and requirements.
  • Must have the ability to work independently with good decision making skills.
  • Must have critical thinking skills.
  • Must have strong organizational skills and the ability to prioritize responsibilities. 
  • Must be able to maintain effective working relationships with internal and external customers.
  • Must be extremely detail oriented with a high level of accuracy while demonstrating the ability to resist distractions.
  • Position requires a friendly, confident and knowledgeable phone presence.
  • Excellent verbal and written communication skills.
  • The position requires proficient computer skills and must be able to use Microsoft Office to complete tasks.
  • Thorough understanding of HIPAA guidelines and regulations in regards to confidentiality and Release of Information regarding medical records. 
  • Practice proper telephone etiquette and provide excellent customer service.



Details

These responsibilities do not reflect all duties the incumbent will be required to perform. This description serves as an overview only. Salary is based on experience. Excellent benefits. Days and hours may vary.


Lakeview Center is an Equal Opportunity/Affirmative Action employer. Minorities, Females, Protected Veterans and Individuals with Disabilities are encouraged to apply. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. Drug Free/Nicotine Free Workplace Employer, DRUG TESTING/NICOTINE TESTING REQUIRED.

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Equal Employment/Affirmative Action employer including Vets and Disabled. For more information, view the EEO is the Law Poster and Pay Transparency Statement. For reasonable accommodation, please email us at LCIEmployment@bhcpns.org.