Implementation Specialist, Billing (EHR billing configuration)

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.

If you want to work inside an atmosphere where innovation has purpose, and your ambition works to support our customers and those they serve, please apply today!

Summary of the Implementation Specialist, Billing

We are seeking a Billing Implementation Specialist to join our team and play a critical role in guiding new customers through the entire implementation lifecycle of our healthcare technology solutions. This position requires a blend of institutional and professional insurance billing expertise, technical knowledge, and exceptional communication skills to ensure successful adoption and compliance with billing and reporting requirements. Deep knowledge of the revenue cycle process is required.

Responsibilities for the Implementation Specialist, Billing

• Interpret how a customer is credentialed with different insurance companies in order to properly configure the software for accurate billing
• Assess billing (insurance and self-pay) workflows and Revenue Cycle requirements; develop collaborative solutions and present recommendations
• Expert knowledge of the Revenue Cycle Management Life Cycle
• Knowledge of UB-04 (Institutional Billing) requirements. Experience in billing for residential, hospital, ASC etc.
• Lead new customer implementations, focused on the revenue cycle management side, from kickoff through go-live, ensuring a smooth and efficient process
• Resolve client inquiries promptly, maintaining ownership through resolution
• Maintain project documentation and communicate updates via agendas, minutes, and project management tools
• Build and sustain positive, productive relationships with customers and internal teams
• Apply consultative techniques to identify customer’s billing configuration requirements and implement best practices
• Review and validate software billing configurations with customer implementation teams
• Ensure quality of configured features and prepare customers for effective end-user training
• Complete product training and demonstrate adaptability across multiple EHR platforms
• Creatively resolve and assess a wide range of billing issues including denials, rejections etc., suggesting alternative approaches as needed
• Document and track all customer billing and reporting requirements to ensure compliance
• Record all customer interactions in CRM according to established standards
• Participate in on-site visits as needed to gather data and understand billing workflows

Qualifications of the Implementation Specialist, Billing

• Bachelor’s degree or equivalent experience required
• Billing experience in behavioral health or general healthcare
• UB-04 (Institutional Billing) knowledge required. Experience in billing for residential, hospital, ASC etc.
• SaaS/cloud implementation experience; EHR/EMR experience preferred
• CPB (Certified Professional Billing) certification a plus

Knowledge, Skills, and Abilities of the Implementation Specialist, Billing

• Strong remote collaboration skills
• Data visualization and reporting analysis expertise
• Familiarity with CCBHC and state-specific billing requirements (NY or CA preferred)
• Knowledge of HIPAA compliance
• Exceptional customer service and communication skills (written & oral)
• Quick, logical problem-solving with attention to detail and follow-through
• Strong organizational and time management skills
• Willingness to travel up to 25%

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.