Insurance Claims Assistant

Community Youth Services is recruiting for a full-time Insurance Claims Assistant. This position is

responsible for processing Medicaid and insurance claims and benefit authorizations.

POSITION QUALIFICATIONS:
1. Education and payroll/claims experience must equal a minimum of three years. If education is

used to meet this requirement, degree/courses must be in a related field. A transcript may be

requested to determine if courses taken qualify.

2. Medical billing and coding certification preferred,

3. Proficiency required in Microsoft Office Suite, and automated and confidential data systems,

4. Working knowledge in claims processing, procedural terminology, and insurance

authorizations, and

5. Proven experience with electronic claim submission, Medicaid claim requirements, and

electronic health record systems.

AGENCY QUALIFICATIONS:
1. The ability to pass an extensive background check with no history of conviction or perpetration

of child abuse or physical harm to another person,

2. Professional and personal conduct that maintains a personal and professional background so

that criminal history remains free from unlawful conduct. Certain crimes may disqualify

employees to have unrestricted access to children or vulnerable populations in accordance

with Department of Social Health and Services policy and Washington State law. Professional

or personal conduct that causes this clearance to be suspended or denied will result in

suspension and/or termination of employment. (Pursuant to RCW 43.43.832, 43.43.832(7),

43.43.834, 43.20A.710 and WAC 388-06.),

3. A valid Washington State Driver License with a three-year good driving record. The ability to

pass and maintain a clean driving records check. Professional or personal conduct that

results in a restricted or denied driving status could result in termination of employment,

4. Proof of personal auto insurance levels at or above a $100,000 combined single limit must be

provided once offer of employment is accepted,

5. Must possess, or obtain within 30 days of employment CPR/1st Aid/Bloodborne Pathogen

certification,

6. A sensitivity and responsiveness to the cultural differences in the organization’s employment

and service population, and

7. Strong interpersonal skills, including the ability to work as part of a team. (EOE).

MAJOR RESPONSIBILITIES AND RELATED TASKS:A. Claims Processing and Client Authorizations:
1. Complete weekly claims processing upload into the Thurston Mason Behavioral Health

Organization (TMBHO) Avatar system from myEvolv,

2. Review and correct claims from the Electronic Data Interchange (EDI) error report in Avatar,

3. Verify accuracy of billable encounter data and revise and request correction of any errors,

4. Complete enrollment and authorization submission for each new client enrolled in Behavioral

Health and Wellness programs,

5. Review and retain medical records in order to compute fees and charges due,

ADMIN Insurance Claims Assistant, 2017

6. Work with Clinical Supervisors and Program Directors, to develop tutorials and train staff

regarding compliance with the Service Encounter Reporting Instructions (SERI),

7. Assist with help desk duties for Current Procedural Terminology (CPT) coding and service

entry issues,

8. Assist with the tracking of staff credentials to ensure claims are not rejected,

9. Assist with planning for private insurance payments for behavioral health programs from a

claims perspective,

10. Attends monthly Avatar SuperUser Meetings at TMBHO, along with, or in place of, the

agency’s Data Systems Administrator, along with any SuperUser training(s),

11. Provide the monthly data certification form to the CFO for signature, and then to the TMBHO

for submission, after Avatar claim imports are completed for each previous month by the 10th

of the following month,

B. Other Duties:
1. Assist with the maintenance of the electronic health record finance module, including, but not

limited to, updates to payors, rate information changes, CPT code updates, etc.,

2. Assists annual audit, behavioral health and wellness program monitoring visits,

Check out our benefit package on our website

http://www.communityyouthservices.org/employment.shtml

ALL ITEMS MUST BE SUBMITTED IN ORDER TO BE CONSIDERED FOR THE POSITION:

1. Resume and cover letter

2. CYS Employment Application http://www.communityyouthservices.org/employment.shtml

There are two versions on our website – a fillable Word version and a printable pdf version.

You can submit either one.

Email to hr@communityyouthservices.org – Reference Insurance Claims Assistant in the subject

line

You will need to submit a driver’s abstract before an interview will be scheduled

$16.07 – $16.98

ADMIN Insurance Claims Assistant, 2017