Mid-Columbia Center for Living

Reimbursement Specialist

The Dalles, OR
Full Time
Finance and Accounting
Entry Level


Working Title: Reimbursement Specialist
Program: Finance
Reports To: Finance Director
Location: On-site, The Dalles (May require work in Wasco, Hood River, and Sherman Counties)
Hours/ FTE: M-F, 8.30 am – 5 pm, 1.0 FTE (37.5 hours)
Pay Range (Dependent on experience):

  •  $21.25 - $25.82/hours 
FLSA Status: Non-Exempt  

Description:

The Reimbursement Specialist processes and documents MCCFL services to ensure the timely collection of receivables from Medicaid, Medicare, and other reimbursement sources.  This position compiles a variety of reports specific to accounts receivable activities, informs management of billing issues, and processes monthly client statements.

Mid-Columbia Center for Living (MCCFL) is a Certified Community Behavioral Health Clinic (CCBHC) that specializes in providing services that are both trauma-informed and recovery-oriented to persons/consumers with mental illness and addictions. Trauma-informed care includes safety, choice, collaboration, trustworthiness, and empowerment for both clients and staff. MCCFL serves Hood River, Wasco, and Sherman Counties and utilizes a consumer-involved, consumer-engaged, and consumer-driven model. MCCFL provides a whole-person care approach to adults and children to address both physical and mental health needs. MCCFL offers a variety of programs including a mobile crisis unit, intensive case management, ongoing counseling, community support, supported employment, jail diversion, hospital discharges, hearings, and more.

Qualifications:

What skills and education do you need:
Any combination of education, licensure, and experience that demonstrates the ability to perform the position’s essential responsibilities is qualifying. This includes:
  • A high school diploma or equivalent, AND
  • Two (02) years of bookkeeping experience that includes demonstrated skill in the use of automated financial system software OR medical billing in a healthcare environment that includes knowledge of procedural and diagnosis codes. Four (04) years of experience preferred.
  • Bilingual fluency in English/Spanish is preferred.
  • Must possess a valid Oregon or Washington Driver’s license and be insurable for travel between business offices or possess an alternative reliable mode of transportation.
  • Must pass all criminal history check requirements as required by ORS 181.536-181.537 and in accordance with OAR 407-007-0200 – 407-007-0370.

What you’ll do:
(The following list represents the essential responsibilities (functions) of the position. It does not, however, represent all of the duties the position may be asked to perform):
  • Compile and review billing data to ensure accuracy of all billing information including Current Procedural Technology (CPT) codes, Oregon Health Plan (OHP) codes, cost center codes, bundling of services, and total fees.
  • Analyze, understand, and interpret billing software upgrades and coding change effects on customers’ accounts receivables.
  • Perform monthly processing of outstanding third-party billing.
  • Monitor aged accounts receivable for assigned payer groups monthly.
  • Take appropriate action to resolve open balances for non-OHP clients. 
  • Inform clinicians of client balances over 60 days for counseling on collection. 
  • Prompt follow-up and correction of billing errors, rejections, insurance company errors, and inquiries.
  • Send monthly statements to clients and separate out special handling statements for alternative processing.
  • Perform data entry tasks in MCCFL’s billing system including third-party payments, electronic health records data, and fee adjustments as noted on reconsideration forms. Review data entry work to ensure accuracy.
  • Inform screeners and providers of client insurance eligibility within 24 business hours of notification for new and re-opened clients. Verify coverage for OHP clients on community partner invoices notifying managers and supervisors of client’s eligibility.
  • Maintain batched billing data and upload to the clearinghouse on a scheduled basis. 
  • Check daily activity in the billing system, input corrections, and advise Business Services of changes. 
  • Prepare and submit encounter measurement data for Mental Health (MH) and Alcohol & Drug (SUD) services to MCCFL’s affiliated Coordinated Care Organizations (CCO) in the format requested, either electronically or on paper.
  • Confirm OHP eligibility through the Medicaid Management Information System (MMIS).
  • Assist and support clients in the OHP enrollment process.
  • Respond to client/staff inquiries regarding billing status providing resolution information in a professional manner.
  • Travel between MCCFL locations and attend required meetings and/or trainings.
  • Regular and reliable attendance; professional communication; maintain confidentiality.

What we’ll do:
We recognize your value and will strive to keep you engaged and appreciated. The selected candidate will receive:
  • Competitive salary, dependent on experience.
  • 95% employer-paid comprehensive medical, dental, and vision coverage for employees only. Low deductible plans for family coverage through PEBB
  • PERS Retirement Contribution
  • 11 Holidays including 1 floating holiday
  • 10 vacation days a year for exempt employees
  • 12 sick days a year
  • Education reimbursement and loan forgiveness- HRSA!

The hiring process:
  1. Application review
  2. Questionnaire (if additional information is needed)
  3. Panel Interview
  4. Possible second-round panel interview
  5. Conditional Offer
    1. DMV Record Review, if the position requires driving
    2. 10 Panel Drug Screen(Although recreational marijuana use is legal in the state of Oregon, you will not be considered for this position if you’re unable to pass a pre-employment drug screening due to federal regulations.)
    3. Criminal History check through Orchards BCU
    4. Reference check
    5. Licensure Primary Source Verification


 

MCCFL provides reasonable accommodations for qualified individuals with disabilities. To request accommodation in the recruitment or selection process, please contact human resources at 541-288-4359 or email hr@mccfl.org.

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