Mental Healthcare Virtual Assistant

As a Mental Healthcare Virtual Assistant with a focus on insurance verification and credentialing, you will play a crucial role in ensuring a smooth and efficient process. You will be responsible for verifying insurance coverage and benefits, obtaining pre-authorizations, managing accounts receivables, coordinating with insurance companies and healthcare providers, handling denied claims, credentialing providers, and ensuring timely reimbursement of medical expenses. Your attention to detail and strong communication skills will contribute to the efficient operation of our office and the satisfaction of our clients.

**Insurance Verification and Billing Responsibilities**
– Uphold the highest standards of quality, courtesy, and commitment when interacting with clients, colleagues, and stakeholders along with addressing client billing inquiries efficiently.
– Create a Quality Assurance document that will be completed for each client that keeps track of all items necessary to manage each client and ensure HIPAA compliance. This will be a template that you will create and after management review and approval, will be used to track that all things are completed and on what date for each client.
– Contact insurance companies via phone, email, or online portals to verify patient coverage and benefits for mental health and behavioral health therapy services.
– Obtain and document accurate insurance information, including policy numbers, coverage details, and authorization requirements.
– Communicate effectively with clients and clinical staff regarding insurance coverage, co-pays, deductibles, and any out-of-pocket expenses.
– Verify that notes are complete before sending out for billing.
– Accurately prepare and submit claims to insurance companies, ensuring proper documentation, either electronically or via paper submissions and coordinate with healthcare providers and insurance companies for follow-up.
– Manage and resolve unpaid or denied claims efficiently, conducting thorough investigations and collaborating with insurance entities for timely resolution. If necessary and reconcile payments and post to clients’ accounts.
– Generate revenue by making payment arrangements, collecting accounts and monitoring and pursuing delinquent accounts.
– Collaborate with the billing department to resolve any discrepancies or issues related to insurance verification.
– Review Claims and EOBs to reconcile insurance payments and manage copays and write-offs.
– Manage account receivables and keep up-to-date records of insurance verification outcomes and maintain organized electronic and paper documentation.
– Stay informed about changes in insurance policies, coverage guidelines, and industry regulations.

**Credentialing Responsibilities**
– Perform the end-to-end steps to ensure credentialing of clinicians with insurance companies and government agencies (“payors”).
– Collect, review, and verify all required documentation, including licenses, certifications, education, training, and work experience.
– Ensure compliance with all applicable regulations, accreditation standards, and organizational policies.
– Maintain accurate and up-to-date credentialing files for each clinician, including updating CAQH profiles for each clinician.
– Monitor expiration dates of clinician credentials and initiate renewal processes as necessary.
– Perform regular follow-up calls and email communication with payors to expedite the credentialing process.
– Track contract expiration dates and initiate renewals or amendments and communicate contract updates in a timely and effective manner.
– Maintain a centralized contract management system for accurate filing and accessibility.
– Liaise with payors to escalate and resolve credentialing and contract-related issues promptly.
– Stay updated on payor policies and billing requirements for compliance and optimal reimbursement.
– Build and maintain relationships with internal departments, external agencies, and payors.

– Maintain accurate data entry and management using Google Sheets and Microsoft Excel.
– Collaborate in achieving company objectives through active participation in meetings and taking notes during meetings.
– Ad hoc administrative tasks.

**Requirements**
– Post-secondary education in nursing, psychology, or other mental healthcare-related field or at minimum prior experience in medical billing or a related field.
– Familiarity with healthcare billing regulations, including HIPAA compliance, to ensure adherence to legal standards.
– Strong understanding and application of medical coding systems such as ICD-10 and CPT codes.
– Must maintain confidentiality and exercise discretion with sensitive information. HIPAA certification is a plus.
– Proficiency in MS Office (MS Excel and MS PowerPoint, in particular), Google Docs and Google Sheets, and electronic medical records (EMR) systems.
– Effective verbal and written communication skills to interact with healthcare providers, insurance companies, and patients. Clear and articulate English communication skills is required as online, and telephone communication is a part of this job.
– Demonstrated ability to be proactive and work hard, both independently and as part of a team.
– Strong time management skills and the ability to prioritize work.
– Organized and high level of accuracy and attention to detail.
– Access to a dedicated, secure computer that is not shared with anyone else and is password-protected.
-Reliable high speed internet connection (with proof of both download and upload speed) and a dedicated home office setup that includes an isolated workspace free of background noise and headset with microphone for online Zoom calls.
– Must be able to work on US Eastern Standard Time (EST).

Application Process
To apply, please share your Intro Video (must be clear and free of background noise so we can hear you clearly) and Resume detailing your relevant experience.

If you do not send an Intro Video and Resume, your application will not be considered.