ServingSchools · 1 day ago
MaineCare Billing Specialist
Farmington, ME
Full-time
Onsite
Entry Level
1+ years expServingSchools is focused on providing high-quality educational opportunities for all. The MaineCare Billing Specialist is responsible for coordinating with various stakeholders to ensure the efficient and accurate submission of MaineCare Billing for school-based services, while also managing Electronic Health Records and monitoring student eligibility.
Education
Responsibilities
Check Acentra and HealthPas (MIHMS) daily for new Prior Authorizations and/or Continued Stay Reviews. Record new authorizations in Therap
Monitor authorization dates to minimize lapses in payment
Communicate with staff re: upcoming due dates for timely submission
Check Unposted Sessions Summary Report (Acuity) monthly and contact providers who are behind in posting and missing student information (ex. ICD-10 codes)
Provide monthly Provider reports to administration with provider activity information (Hours/sessions/unposted)
Review non-billable & missing information reports from EDMS and communicate to providers items to correct for OT, PT and ST
Monitor Authorization and ITP/ISP expiration dates, communicate with Clinicians to be sure there is not a lapse in billing eligibility
Understand, manage, and coach providers in the use of Electronic Health Records
Communicate with EDMS and Therap to solve any difficulties staff may have
Distribute instruction material, organize training, etc. as needed
Provide EDMS with rate sheets for OT, PT and SL
Collect and file signed Statement of Reassignment forms
Collect signatures and file signed Electronic Signature Verification forms
Assist staff with registration for BHP training. Collect and file BHP certificates and service provider licenses
Collect and record Parental Consent for MaineCare Billing
Monitor Student MaineCare eligibility
Communicate with staff to ensure all Sessions/ISP Data are completed in a timely manner so billing can occur
Submit claims (837 transactions) to MIHMS weekly
Post MaineCare payments (835 transactions) received to Therap
Send monthly reimbursement reports to the Finance manager
Research/resubmit denied and/or suspended claims
Update Therap by adding/discharging students and staff
Review SEED Payment Report quarterly through NEO
Maintain Provider information in the MIHMS portal
Update rates and modifiers as needed
Add new staff accounts to Therap and Acentra
Check monthly for late documentation and send claims
Maintain strict confidentiality
Qualification
Required
One year experience in health care billing
Experience with computerized billing systems, spreadsheets and word processing programs
Strong oral and written communication skills
Valid CHRC - Maine DOE Background Check
High School Diploma required
Preferred
Experience in the mental and behavioral health care industry
Associate's Degree in business or significant related training and experience preferred
Benefits
Earned vacation and sick time
Company
ServingSchools
ServingSchools is an online marketplace providing schools, agencies and job seekers a fast and easy way to find each other.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase