Position Details
About this role
This role involves auditing paid behavioral health claims, identifying underpayments, and managing reprocessing efforts to ensure accurate reimbursement for mental health and substance use disorder services.
Key Responsibilities
- Audit paid claims
- Identify underpayments
- Manage reprocessing requests
- Review payer discrepancies
- Maintain detailed documentation
Technical Overview
The position requires experience with claims auditing, behavioral health billing, CMD, and payer reimbursement methodologies, with proficiency in relevant billing and data management tools.
Ideal Candidate
The ideal candidate is a detail-oriented professional with at least 2 years of experience in behavioral health billing, claims auditing, and reimbursement processes. They are proficient with CMD and familiar with third-party payers, capable of working independently in a remote setting.
Must-Have Skills
Nice-to-Have Skills
Tools & Platforms
Required Skills
Hard Skills
Soft Skills
Industry & Role
Keywords for Your Resume
Deal Breakers
Less than 2 years' experience in behavioral health billing, Lack of experience with CMD, Inability to work remotely, No experience with claims auditing
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