Medical Billing and Resolution Specialist Oregon Community Programs Eugene, OR Job Details Full-time $52,000 - $54,080 a year 1 day ago Benefits Paid holidays Health insurance Dental insurance 401(k) Flexible spending account Paid time off Employee assistance program Vision insurance 403(b) Professional development assistance Flexible schedule Life insurance Retirement plan Qualifications Teamwork Defect resolution root cause analysis Spreadsheets Medicaid health insurance ICD-10 Electronic health record (EHR) management for billing and coding Attention to detail Medicaid Document viewing software Productivity software Root cause analysis Associate's degree Medical terminology Excel data analysis Full Job Description Oregon Community Programs (OCP) provides behavioral and mental health services to children, youth, and families across a variety of settings, including families of origin, kinship care, foster care, and Treatment Foster Care. As the Billing and Resolution Specialist, you will play an essential role in managing OCP's healthcare revenue cycle. You will learn our billing cycle and Electronic Health Records system, work to resolve outstanding claims, and collaborate with clinicians to address claim discrepancies. Our ideal candidate has experience with claim adjudication, payment and recoup postings, and denial management, along with strong attention to detail and problem-solving skills. This role is a great fit for someone who enjoys the detective work of research, investigation, and problem-solving. We're looking for someone who is curious, eager to learn, and motivated to identify opportunities for improvement. At OCP, we value connection and offer a supportive, collaborative, and dog-friendly work environment with staff social events. You'll have the opportunity to work independently and as part of a team while making a meaningful difference in the lives of children and families. This is a full-time position.

MINIMUM QUALIFICATIONS

Associate's degree in a related or relevant field. 3 years' experience in complex medical billing and root-cause analysis to resolve billed insurance claims. Proficient in full Microsoft Office Suite, with an intermediate skill in Excel, and additional emphasis on creating and working with pdfs (will be tested). High level of confidence and comfort learning new EHRs, software, and programs. Recent knowledge and experience working with Medicaid claims. Working knowledge of payor guidelines, medical terminology, CPT/ICD-10 coding, and insurance billing/reimbursement practices.

PRIMARY RESPONSIBILITES OF THIS POSITION

Verify client eligibility & benefits using MMIS & other payor portals and manage all follow-through. Audit weekly OHP Eligibility Spreadsheet and make necessary updates in all systems. Submit, track and record claims submissions within EHR and Clearinghouse systems. Work, resolve and document Clearinghouse rejected claims, payor denied claims, outstanding claims, and EHR failed claims to ensure timely, accurate, and maximum reimbursements. Submit corrected claims, claim reconsiderations/appeals, and/or claim projects. Post payments, adjustments, and maintain detailed records in EHR/billing systems with a high level of accuracy. Annotate and process utilizing pivot tables. Maintain clear, accurate, and thorough documentation, strong tracking systems, consistent follow-through, and effective oral and written communication. Perform other duties as assigned. Includes cross-training to provide vacation/sick coverage for fellow team members.

OUR IDEAL CANDIDATE

Oregon Medicaid and Coordinated Care Organizations, including MMIS Behavioral health claims CareLogic EHR Pivot tables Liaison between patients, providers, and insurance companies. Commitment to integrity and accountability

DIVERSE CANDIDATES ENCOURAGED TO APPLY

Studies have shown that women and people of color are less likely to apply for jobs unless they believe they are able to perform every task in the job description. We are most interested in finding the best candidate for the job, and that person may be one who comes with relevant transferable skills from a variety of sources and experiences.

Benefits & Perks:

403(b) Plan Family Friendly Employer Retirement Contributions Flexible Spending Plan Relaxed Work Environment Excellent Admin Support Flexible Work Schedule Medical, Dental & Vision (90% employer paid) Staff Social Events Employer Paid Life Insurance Employee Assistance Plan (Access to FREE appointments with a mental health counselor, & other supportive benefits) Paid Vacation Days Personal & Sick Time Paid Holidays & Office Closures (12 days) Dog Friendly Office Health Reimbursement Arrangement Starting salary range: $52,000-54,080/year, higher depending on experience and other pay equity differentials. Eligible for compensation increase up to 3% at 6 months.

What we offer:

Welcoming team atmosphere, flexibility, and appreciation for having a life outside of work. We model and promote communication that fosters connection, respect, and honoring each other's strengths and differences. An opportunity to change the lives of young people and their families.

Competitive benefits:

Comprehensive medical and dental insurance, including prescription, vision, and alternative care coverage (90% employer paid), life insurance, employer retirement contributions to 403(b) plan, and more.

Paid time off:

33 paid holiday and vacation days/year, separate accrual for sick time. Dog friendly office, fun staff social events, people-centered culture.

OCP IS AN EQUAL OPPORTUNITY, AFFIRMATIVE ACTION EMPLOYER. OCP

is a healthcare facility and abides by Oregon Health Authority's rules around COVID vaccinations in all healthcare. Must be fully vaccinated against COVID.

Job Type:

Full-time Pay:

$52,000.00 - $54,080.00 per year

Benefits:

401(k) Dental insurance Employee assistance program Flexible schedule Flexible spending account Health insurance Life insurance Paid time off Professional development assistance Retirement plan Vision insurance

Education:

Associate (Required)

Experience:

medical billing: 3 years (Required)

Work Location:

In person