Outpatient Credentialing, Contracting, and Billing Manager

NOVA Behavioral Health

Greenville, NC

Full-time

NOVA Behavioral Health is looking for a Outpatient Credentialing, Contracting, and Billing Manager to join our team of professionals. We are looking for someone that brings a positive and professional customer-service attitude to our business. If you are interested in joining a growing, successful company, then we want to talk to you!

What will your day look like as a Credentialing, Contracting, and Billing Specialist?

• Assisting the CFO and Program Director in fiscal management activities for the organization
• Managing billing of Medicaid and other entities for NOVA’s community behavioral health services
• Initial credentialing and contracting of providers, and maintaining provider contracts with payors
• Managing prior authorizations for NOVA’s community behavioral health services.
• Assisting the CFO and Program Director with the management of NOVA contracts with payors

What will you do as a Credentialing, Contracting, and Billing Specialist?

• Responsible for all billing and payments for NOVA’s community behavioral health services
• Resolve discrepancies in submitted claims, billings and collections, and reports potential problems
• Responsible for reporting insurance payments and patient responsibility payments
• Responsible for maintaining billing records on all patients
• Check insurance eligibility for patients and maintains updated insurance information, including co-pay amounts, in the EHR
• Communicate estimated patient financial responsibility in advance of scheduled services to patients/ guardians, other administrative staff and providers
• Prepare and send invoices and statements for patients
• Responsible for prior authorizations, including: Submitting and maintaining prior authorizations coordinating with patients and NOVA personnel to obtain all documentation needed to gain authorizations, and maintaining updated authorization documentation.
• Support the CFO and Program Director in the management, revision, and renewal of all NOVA contracts with payors
• Ensure that NOVA providers are appropriately credentialed with necessary payors including credentialing new NOVA providers as well as renewing credentialing for NOVA providers
• Credential and establish new locations with all payers
• Maintain and share contracted payer changes and information with Program Director, CFO and other appropriate individuals
• Provide correspondence and other clerical activities relative to all primary functions
• Maintain a harmonious working relationship with co-workers and communicates pertinent matters to management in a timely manner
• Assure that all fiscal standards, policies, and procedures are implemented, and informs the CFO and Program Director of potential errors, exceptions, or problems
• Complete other duties as assigned

Qualities

• Excellent computer skills
• Organized
• Detail oriented
• Good communication skills
• Team player
• Willing and excited to learn
• Self-motivated/Takes initiative
• Flexible
• Strong work ethic|

• High School Diploma or equivalent
• Excellent computer and typing skills
• Attentive to detail
• Effective organizational and communication skills

Preferred Skills

• Associate degree
• Previous experience with medical/mental health billing highly preferred
• Previous experience as a Claims Analyst highly preferred
• Previous experience with insurance/payor contracts managing and maintaining contracts highly preferred
• At least one year of previous business experience highly preferred