Job Description:
Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts’ comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients. Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions.
Key Responsibilities:
1. Accurate Payment Posting:
- Accurately post all insurance and patient payments by line item using medical claim billing software.
2. Meeting Payment Posting Deadlines:
- Meet deadlines for posting payments to ensure timely reconciliation of accounts receivable.
3. Interpretation of Explanation of Benefits (EOBs):
- Read and interpret insurance EOBs to reconcile payments, denials, and adjustments for accurate posting.
4. Attendance at Staff Meetings and Educational Sessions:
- Regularly attend monthly staff meetings and participate in continuing educational sessions to stay informed about industry updates and best practices.
5. Additional Duties as Requested:
- Perform additional duties as requested by the supervisory or management team to support departmental objectives.
6.Training and solving queries:
- To help the team with their queries and concern, help the team to reach their goals and required accuracy while posting.
7. HIPAA Compliance:
- Follow HIPAA guidelines and maintain patient confidentiality when handling sensitive information during payment posting processes.
8. Data Security and Integrity:
- Maintain the security and integrity of practice data being worked on to protect sensitive information and comply with regulatory requirements.
9. Revenue Cycle Performance Analysis:
- Obtain a clear view of revenue cycle performance through accurate payment posting and data analysis.
10. Policies and Procedures Development:
- Develop exhaustive policies and procedures for write-offs and adjustments to ensure consistency and compliance in financial transactions.
Qualifications:
- High school diploma or equivalent; associate or bachelor’s degree in healthcare administration, Commerce/Arts or related field preferred.
- Minimum of 3 to 4 years of experience in medical billing or revenue cycle management, with a focus on payment posting.
- Strong attention to detail and accuracy in data entry and payment reconciliation.
- Knowledge of medical billing software and electronic health record (EHR) systems.
- Familiarity with insurance EOBs and payment reconciliation processes.
- Understanding of HIPAA regulations and patient privacy requirements.
- Excellent communication and interpersonal skills.
- Ability to work independently and collaboratively in a fast-paced environment.
- Commitment to meeting deadlines and achieving departmental goals
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Skills Required
- High school diploma or equivalent
- Associate or bachelor's degree in healthcare administration, Commerce/Arts or related field
- 3 to 4 years of experience in medical billing or revenue cycle management
- Strong attention to detail and accuracy
- Knowledge of medical billing software and EHR systems
- Familiarity with insurance EOBs and payment reconciliation processes
- Understanding of HIPAA regulations
- Excellent communication and interpersonal skills
- Ability to work independently and collaboratively
- Commitment to meeting deadlines and achieving departmental goals
What We Do
Qualifacts' CareLogic Enterprise Software is a comprehensive Electronic Health Record (EHR) designed for behavioral health, mental health, & human services.
