ESD 113 Behavioral Health Billing Specialist

Accounting and Finance

ESD 113 - Integrated Student Support6005 Tyee Drive SWTumwater, WA 98512

Other

$29.59 - $35.97 per hour

ESD 113 - Integrated Student Support

Best to Apply By: 5/1/25. Job will be open until filled.

Capital Region ESD 113 is committed to closing gaps, growing people, influencing change, and eradicating racism through our service to our region and state. BIPOC as well as culturally and linguistically diverse candidates are strongly encouraged to apply.

The job of Behavioral Health Billing Specialist is done for the purpose/s of assisting in Behavioral Health revenue cycle operations. The individual in this role is responsible for various billing tasks, including submitting claims to insurance companies, tracking their statuses, and other aspects of reimbursement collection while adhering to regulations and compliance standards; as well as providing program support and services consistent with internal practices and procedures.

This position is between 180-260 days/year, 6-8 hours/day.

Benefits may include Medical/Vision/Dental Insurance; FSA/DCAP; Life/AD&D Insurance; LTD Insurance; EAP; Retirement; DCP; Annual Leave, Sick Leave Holiday Pay and Personal Leave.

Required attachments: Transcript, Resume and Cover Letter

Please see the job description below for a list of Essential Functions and Job Requirements.

Behavioral Health Billing Specialist Job Description

Purpose Statement

This job is distinguished from similar jobs by the following characteristics: Per the essential functions and educational requirements listed below.

This job reports to Executive Director - Integrated Student Support- Prevention, Intervention and Wellness or designee

Essential Functions

Assists in developing, reviewing, and editing internal medical billing and contracting procedures, processes, and supporting documents for the purpose of ensuring compliance with state and federal regulations.
Gathers data on various processes, procedures, and loss runs for the purpose of identifying trends and developing protocols.
Maintains files and records for the purpose of documenting actions and ensuring compliance with state statutes, rules, policies, and internal procedures.
Monitors unaccepted and denied claims and manages corrections and appeals for the purpose of monitoring and responding to claim deficiencies.
Prepares a variety of written materials (e.g. memos, invoices, reports, billings, letters, daily/monthly/quarterly/year-end reports, spreadsheets, account codes, budgets, etc.) for the purpose of documenting activities, providing written reference, conveying information and/or complying with financial, legal, and administrative requirements.
Prepares and submits billing claims to appropriate payors for the purpose of ensuring proper reimbursement from assigned payors.
Recommends process improvement goals, objective and changes to policy and procedures for assigned activities for the purpose of improving revenue cycle management and organizational processes.
Reconciles payor payments deposits by matching outgoing claims to incoming funds for the purpose of ensuring accurate account code balances.
Responds to inquiries from a variety of sources (e.g. client families, insurance companies, other relevant stakeholders, etc.) for the purpose of facilitating communication among parties and providing information.
Reviews reports to identify services where a guarantor is not identified. Works with appropriate parties to identify guarantors, if applicable, for the purpose of ensuring accurate billing practices.
Reviews, posts, and/or corrects health care claim payments (835 postings) from insurance for the purpose of ensuring accurate account code balances.
Runs monthly insurance eligibility for clients enrolled in services and communicates discrepancies with families and program staff for the purpose of determining financial eligibility for various payors.
Supports the billing team by tracking and posting client/private payments. Develops and provides self-pay statements for the purpose of verifying accuracy of information and maintaining accurate balancing.

Marginal Functions

Assists other personnel as may be required for the purpose of supporting the completion of work activities.
Performs other related duties as assigned for the purpose of ensuring the efficient and effective functioning of work within the unit.

Job Requirements: Minimum Qualifications

Skills, Knowledge and Abilities

SKILLS are required to perform multiple tasks with a need to occasionally upgrade skills in order to meet changing job conditions. Specific skill based competencies required to satisfactorily perform the functions of the job include: operating standard office equipment; using pertinent software applications commonly used or applied in health care billing operations; planning and managing special projects; performing accounting procedures; and preparing and maintaining accurate records.

KNOWLEDGE is required to perform algebra and/or geometry; read technical information, compose a variety of documents, and/or facilitate group discussions; and solve practical problems. Specific knowledge based competencies required to satisfactorily perform the functions of the job include: healthcare billing practices, commercial insurance and Medicaid contract billing guidelines.

ABILITY is required to schedule activities, meetings, and/or events; gather, collate, and/or classify data; and use job-related equipment. Flexibility is required to work with others in a variety of circumstances; work with data utilizing defined but different processes; and operate equipment using standardized methods. Ability is also required to work with a wide diversity of individuals; work with a variety of data; and utilize job-related equipment. Problem solving is required to identify issues and create action plans. Problem solving with data requires independent interpretation of guidelines; and problem solving with equipment is limited to moderate. Specific ability based competencies required to satisfactorily perform the functions of the job include: communicating with diverse groups; working with frequent interruptions; working with detailed information/data; maintaining confidentiality; establishing effective relationships; adapting to changing work priorities; and thinking critically and executing processes efficiently.

Responsibility

Responsibilities include: working under limited supervision following standardized practices and/or methods; leading, guiding, and/or coordinating others; monitoring budget expenditures. Utilization of resources from other work units is often required to perform the job's functions. There is a continual opportunity to impact the organization's services.

Work Environment

The usual and customary methods of performing the job's functions require the following physical demands: occasional lifting, carrying, pushing, and/or pulling, some stooping, kneeling, crouching, and/or crawling and significant fine finger dexterity. Generally the job requires 85% sitting, 10% walking, and 5% standing. This job is performed in a generally clean and healthy environment.

Experience

Job related experience with increasing levels of responsibility is required.

Education (Minimum)

High school diploma or equivalent.

Equivalency

Job related experience in a healthcare setting with increasing levels of responsibility is required. At least five years' experience in behavioral health billing and working with electronic health record systems, preferred.

Required Testing

None Specified

Certificates and Licenses

None Specified

Continuing Educ. / Training

None Specified

Clearances

Criminal Fingerprint Background Clearance WA State Sexual Misconduct Disclosure Release

FLSA Status

Non Exempt

Salary Grade

Capital Region ESD 113 is an Equal Opportunity Employer