This position is responsible for ensuring all primary and secondary claims for Lakeview Center Inc. (LCI) and West Florida Community Care Center (WFCCC) are processed timely and accurately into the electronic claims processing system and are in compliance with State, Federal, Contractual and Agency standards. The employee must have the ability to use effective analytical skills to resolve problems as they arise. Claims are processed into the Florida Medicaid Portal and the clearinghouse weekly. Access Behavioral Health (ABH) claims are uploaded into the internal system for processing bi-weekly. Ensure Employee Assistance Program (EAP) and assigned contract billing claims are processed and claimed monthly. Monitors trends in denials and educates the billing office staff as needed. Creates the billing error report for the Compliance Department. Reviews all claims prior to processing and communicates any corrections needed with the appropriate staff. Processes all rebills for corrected and appealed claims. Responds timely to claims adjudication inquiries. Coordinates claim management with Access Behavioral Health staff and reports any concerns to the department manager. Assist with reports and audits as requested by the Department Manager or the Department Director. Works closely with Department Managers and the Department Director to assist with special projects.
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.
• Associate (AA) degree.
• Three (3) years relevant medical business office experience.
• High school diploma or GED with five (5) years related experience may be substituted.
• 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 release 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.
Interested applicants please visit www.elakeviewcenter.org and complete the on-line application. If you require additional assistance, please call Human Resources at 850-469-3729.
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.
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.