|Skills:||coding,billing,denial management,problem solving,process-building,education
|Specialties:||primary care, medicare, collaborative care
|Required Experience:||3 to 4 years
|Preferred Experience:||5 to 7 years
|Location:||San Diego, CA* Note: This listing is for a remote position
Concert Health is a national organization providing behavioral health services to primary care practices. Our medical group helps doctors (mostly primary care) deliver exceptional behavioral health services to their patients, following the Collaborative Care model. We employ remote care managers and psychiatric consultants and provide enabling technology to help them identify and treat patients with behavioral health needs.
We are growing quickly and working with new provider partners all the time. Our partners need our help not only in providing great clinical care, but also in making sure they are properly reimbursed for Collaborative Care services.
We are looking for a certified biller and coder to help a diverse set of practices across multiple states properly bill for these services. The right person will be not only an experienced and confident coder, but an excellent communicator, a natural problem solver, and a process-builder.
He/she must bring expertise and energy to this problem today, while also building the processes to do it effectively with an ever larger and more diverse set of partners. Only one role is available; we have listed it repeatedly because we are flexible on geography.
- Work with Concert’s finance and clinical teams to better support each of the partners we have today: unravel and solve existing problems, and research and resolve discrepancies, denials, appeals, and collection
- Work hand-in-hand with Concert’s practice partners to set up billing processes at implementation start to facilitate correct timely billing and denial management
- Create processes and tools that enable Concert and its partners to optimize billing and reimbursement for the new CMS Integrated Care codes across a practice’s payer mix
- Proactively optimize processes and create a playbook (e.g., EMR billing templates, sample claim forms, etc.) to facilitate doing this at a much larger scale: both as Concert brings on more partners, and our provider partners grow in size and complexity
- Are extremely attentive to detail, and have experience entering, managing, and manipulating data accurately in a fast-paced environment
- Have demonstrated capacity to balance competing priorities and continue to execute projects with excellence
- Are a strong communicator, verbally and in writing; you enjoy working with people
- Are highly independent in your work and naturally drive projects to completion
- Are as comfortable being deep in the weeds (e.g. getting to the bottom of an individual claim form) as you are building processes and plans to handle this at 1,000x the volume
- Have the tech skills to design and build an efficient, tech-driven process in what is often a paper / spreadsheet driven world
- Are excited about helping people access treatment for behavioral health needs
- Certified biller and coder with specific primary care expertise and experience in large and small system billing operations (minimum 5 years)
- In-depth understanding of multiple EMR systems’ billing functionality, electronic and paper claim submission
- In-depth knowledge of medical billing processing protocols, payment schemes, adjustment processing, medical terminology, CPT, and revenue codes
- Extensive knowledge of Medicare, Medicaid, and commercial payer billing and reimbursement
- Familiarity with medical billing software (e.g., Lytcec, Medic, Misys, Medisoft, NextGen, IDX, etc.) and coding software (EncoderPro, Flashcode, Codeline, etc.)
- Familiarity with value-based billing models (e.g., ACO, capitation contracts)
- Experience handling Personal Health Information (PHI) in a professional manner.
Bonus Points for:
- Specific knowledge of the 99492, -494 and 99484 codes and related billing requirements