Billing Analyst - Electronic Health Records (EHR) - HealthRIGHT 360 : Job Details

HealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment.

Benefits and perks:

• HR360 offers a robust benefits package, including PTO, 15 paid holidays, commuter benefits, retirement plans, and more!
• Employees qualify for public loan forgiveness programs
• Training and professional development opportunities
• Work with mission driven, compassionate colleagues and make a difference every day in the work that you do.

This position is union eligible. The EHR department is in charge of managing all operations for our electronic health record systems, including training and support for all EHR users, as well as electronic billing and data reconciliation. We are a fast-paced, customer-service focused department with a goal to support all programs in providing the best client and patient services possible. The Electronic Health Records (EHR) department is integral to our operations, ensuring that all electronic health record systems function optimally and that all users receive the necessary training and support. As a fast-paced, service-oriented department, we aim to empower all programs in delivering the best possible client services.

The EHR Billing Analyst is responsible for working with the rest of the EHR Billing Team and the Fiscal Department to reconcile and submit monthly billing, as well as managing singular and recurring reporting needs for funders/contracts. This position will take the lead in problem-solving around reconciliation and billing issues in the electronic health records (EHR) billing system. In addition, they will assist the EHR Billing & Data Manager in working through implementations to build out billing systems for new programs or funding streams. This role involves configuring fee schedules, billing codes, and pay sources, as well as updating fee schedule rates to ensure accurate billing processes. Furthermore, the EHR Billing Analyst will create and post billing cycles, submit claims to the County, analyze and correct denied/rejected claims, investigate billing violations and not gathered services, and act as an escalation support agent for the help desk. Finally, this position will work to maintain and troubleshoot API integration and other forms of data exchange between our internal EHR and our funders' systems.

Key Responsibilities:

• Billing: Maintenance and organization of EHR payors and fee schedules.
• Configure fee schedules, billing codes, and pay sources.
• Update fee schedule rates.
• Create and post billing cycles.
• Submit claims to the County.
• Analyze and correct denied/rejected claims.
• Analyze and correct billing violations and not gathered services.
• Escalation support agent for the help desk.
• Communication and cooperation with EHR and fiscal teams.
• Attend and participate in department, inter-team, and agency meetings as appropriate.
• Other duties as assigned.
• Process: Utilize problem-solving skills to create more efficient, stable systems for setting up, monitoring, and rectifying EHR billing.
• Implementations: Assist the EHR Billing & Data Manager and/or EHR Billing Manager in implementing billing systems for new programs or funding streams.
• Intangibles: Develop and maintain effective working relationships with fiscal and clinical leadership. Incorporate agency philosophy and mission in all aspects of job performance. Maintain confidentiality regarding clients, families, and operations of the agency in accordance with HIPAA and 42 CFR Part 2. Exercise good judgment in the performance of duties and responsibilities. And other duties as assigned.

Qualifications: Education, Experience, or Certification:

• Minimum of 3 years' experience working in EHR (Welligent Billing and/or other County systems) OR Master's degree or higher.
• Experience in claim analysis and investigation.
• Experience with billing software and reporting.
• Experience in Help Desks.
• Knowledge of HIPAA and CFR 42.
• Pass EHR Analyst Competency Test.
• Previous non-profit behavioral/mental healthcare agency experience preferred.

Background Check and Other Requirements:

• Qualified candidates with arrest and conviction records will be considered for employment.
• Must be capable of completing a background check and livescan.