Behavioral Health Medical Billing Specialist

MyAdvisor/VetAdvisor care coordination program provides expert care for those that serve others. From Behavioral Health to career development, MyAdvisor will triage individual needs to find the best resources for ongoing support.

With over 12 years of proven success, MyAdvisor provides support to those who are responsible for the safety and welfare of others. Three Wire delivers practice, preventative, and integrated care coordination to private and public sector employers. This care coordination, in turn, supports clinical tele-Behavioral Health, holistic wellness, navigational advocacy and family stability, and thus helps individuals thrive in their career and family life.

Shift: Monday-Friday 12:30pm-9pm

Candidate must live within 1 hour of Ebensburg location

Job Summary:

• Provides outstanding customer service related to Veteran care through the Community Care Network (CCN) in a fast-paced contact center.
• Responds to inbound calls and chat messages regarding authorizations for medical and Behavioral Health care, provider status and availability, or claims payment and status.
• Accurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols.
• May make outbound calls to schedule appointments based on Veteran or VA request.
• Resolves administrative eligibility discrepancies through account research and review.

Essential Duties and Responsibilities:

• Manages multiple tasks lists in accordance with directed timelines.
• Meets call volume, chat volume, schedule adherence, quality, Veteran appointment and other production standards.
• Initiates and receives phone calls, chat messages and emails from VA medical center staff, and providers to answer claims, eligibility, benefit and program questions.
• In select markets, facilitates appointment scheduling of Veterans through outbound solicitation to providers.
• Records preferences, tracks Veteran questions thoroughly in the TriWest’s Customer Relationship Management systems and Portal, as well as VA’s HSRM systems.
• Consistently displays professional and courteous service skills to internal and external customers.
• Accurately resolves VA and provider inquiries with a focus on first call resolution
• Protects the privacy of health information of patients when using or disclosing Protected Health Information (PHI).
• Takes appropriate measures to comply with HIPAA regulations to protect privacy of customers' health information.
• Documents all communications involving Veteran and provider contacts.
• Uses critical thinking in problem solving and follows established processes to assure quality program compliance.
• Consistently meets department productivity and performance metrics to include regular and consistent attendance.
• Participates in cross training, employee development and flexible assignments to ensure business needs are met.

Education and Qualifications:

• High School diploma or GED
• Must have call center experience
• One year experience in a customer service role with performance metrics
• Experience using Microsoft Office products and the Internet
• Healthcare industry experience to include knowledge of health services
• Contact center experience to include call center chat messaging
• Military experience focusing on service delivery PREFERRED

Supervising Others: No

Travel: Up to 10%

Work Environment: Remote, 1 week onsite training

Mission Responsibilities:

• Contributes to achievement of the Mission and Vision of our organization
• Adapting to Change-Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives
• Continuous Improvement-Acts to constantly improve the level of clinical and non-clinical outcomes and level of customer satisfaction in both individual and teamwork processes
• Client Centered Focus-Demonstrates concern for meeting or exceeding customer’s expectations/requirements in a manner that allows the client to guide rehabilitation process towards the achievement of their goal(s) and which provides satisfaction for the customer
• Teamwork-Accomplishes tasks through working effectively with others and appreciating the value, contributions, and commitment of every team member.

Physical Demands: works in office areas, sits, stands, bends, lifts and moves intermittently during working hours. Uses personal computer, telephones, copiers, printers, and other office equipment. The employee must occasionally lift and/or move up to 10 pounds.

To perform this job successfully, an individual must be able to perform each essential function satisfactorily, with or without reasonable accommodation. Reasonable accommodations will be provided in the Three Wire Systems San Diego office location only. The list of requirements, duties, and responsibilities is not exhaustive but is representative of the current job. The knowledge, skills and/or abilities listed are typically required to perform this job successfully. Reasonable accommodations may be made to enable functions. Management reserves the right to revise the job description and to require that other tasks be performed when the circumstances of the job change (for example: emergencies, changes in personnel, workload, or technical development).