Behavioral Health Support Specialist

Behavioral Health Support Specialist

Department: Behavioral Health

Program: Behavioral Health

Reports To: Behavioral Health Manager

Employment Status: Full Time

FLSA Status: Non-Exempt

Schedule: 40 Hours/52 Weeks

Preference: TERO Ordinance 2017-01, P.L. 93-638

Job Summary

The Behavioral Health Support Specialist is responsible for managing a variety of administrative tasks within the Electronic Health Record. These tasks include insurance verification; compliance verification with documentation standards for both billing and state regualtions; complex clerical functions for patient billing; assisting resolve claim denials; overseeing sliding fee scale agreements; and liasing with third-party billing processors. The Behavioral Health Support Specialist works with others in a team environment, including members from Tribal Finance, Health Administration, and contractors. The Behavioral Health Support Specialist will develop a working knowledge of Behavioral Health regulations and documentation standards as part of their on-the-job learning.

Essential Functions

• Responsible for ongoing improvement of process efficiencies and internal controls
• Review documentation to ensure accuracy and compliance based on Federal and State regulations
• Review Coordination of Benefits and payer sequencing to confirm accuracy
• Efficient and timely submission of service documentation corrections and resubmissions
• Verify accurate encounter information in the Electronic Health Record
• Research denials and zero payments, respond to inquiries and requests as needed
• Prepare reports summarizing Department goals and benchmarks related to documentation, claims, and productivity goals
• Maintain confidentiality of patient health information
• Ensure compliance with Tribal, Federal, State, and local employment laws and regulations Tribal policies, and Tero Ordinance

It is the intent of this job description to highlight the essential functions of the position; however, it is not an all-inclusive list. The incumbent may be called upon and required to follow or perform other duties and tasks requested by his/her supervisor, consistent with the purpose of the position, department and/or the Kenaitze Indian Tribe's objectives.

Working Conditions

Lifting Requirements

• Light work - Exerting up to 20 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects

Physical Requirements

• Stand or Sit (Stationary position)
• Walk (Move, Traverse)
• Use hands/fingers to handle or feel (Operate, Activate, Use, Prepare, Inspect, Place, Detect, Position)
• Climb (stairs/ladders) or balance (Ascend/Descend, Work atop, Traverse)
• Stoop, kneel, crouch or crawl (Position self (to), Move)
• Talk/hear (Communicate, Detect, Converse with, Discern, Convey, Express oneself, Exchange information)
• See (Detect, Determine, Perceive, Identify, Recognize, Judge, Observe, Inspect, Estimate, Assess)
• Taste/Smell (Detect, Distinguish, Determine)
• Pushing or Pulling
• Repetitive Motion

OSHA Categories

• Category II - Normal routine involves no exposure to blood, body fluid or tissue, but exposure or potential for exposure may occur

Equipment and Tools

List Equipment used for job: phone, computer, file cabinet, fax, cell phone, car

Drives KIT or Personal Vehicle: Yes

Travel

• Local
• In-State

Qualifications

Education

• High School Diploma or equivalent required

Experience

• Understanding and experience of documentation required for compliance with Behavioral Health regulations required

Preferred

• Three (3) years of billing revenue cycle experience
• Alaska Behavioral Health billing experience (State Plan and/or 1115 Waiver)
• Experience with tribal/IHS billing and reimbursement
• Knowledge and experience working with cultural diversities
• Understanding and experience of Behavioral Health Current Procedural Terminology (CPT) coding preferred

Licenses and Certifications

• Must have a valid Alaska State driver's license and must remain insurable under the Tribe's policy, or obtain within 90 days of hire, or, with approval of the hiring manager, sign a *Memorandum of Understanding (MOU) in lieu of having a driver's license to perform the required duties of the position (If Applicable)

Special Skills

• Proficiency with Microsoft Suite, or obtain training within 90 days of hire
• Conducts business in a service-oriented manner that is pleasant, attentive, respectful, and kind when dealing with un'ina, visitors, co-workers, and others
• Demonstrates ability to manage multiple goals, projects, and deadlines
• Ability to multi-task, work independently, and meet deadlines

This position is a Covered Position subject to all requirements of the Alaska Barrier Crimes Act (ABCA) and to the Indian Child Protection and Family Violence Prevention Act, (ICPA). ABCA and ICPA requirements apply and must be complied with at all times in order to remain in the position

*Memorandum of Understanding: Serves as documented evidence that the Kenaitze Indian Tribe has expressed the ineligibility of an employee to operate motor vehicles owned, leased or rented by the Kenaitze Indian Tribe, or to operate a personal vehicle on behalf of the Kenaitze Indian Tribe.