Why Work for Gandara:

Explore the career pathways in Behavioral Health, Substance Use and Recovery, Community Based Clinical services, Adolescent and Family services, Adult Residential, Maintenance and Administration! Whether that is in an entry level or leadership role, Gandara will provide the tools and resources to better enhance your career growth. The opportunities are presented with the ability to transition your skills and experience in meeting the organizations mission. There is grand landscape of opportunities that supports the community we serve, so Join the Gándara team today!

Benefits:

Retirement Plan 403(b) Health, Dental, Vision, Pet and Life Insurance Paid vacations Paid holidays 8 discretionary days Mileage Reimbursement

Job Title: Billing Claims Specialist

Work Location: Springfield, MA

 

*Bilingual Candidates Encouraged to Apply 

*EOE M/F/D/V

*Union/Non-Union

 

Job Summary:

The Billing / Claim Specialist I, reporting directly to the Billing Director, will join our Billing Department to be an integral part of our mission to provide culturally sensitive behavioral health, substance use, preventative, and educational services to more than 15,000 adults, children, and families.

Duties and Responsibilities:

Performs the electronic file transfer for all insurances. Processes and prepares paper claims for primary and secondary insurance submissions. Manages and post payments and denials from insurance remittances, as well as processes and post adjustments and denials as noted by contracts. Investigates and reports denials and denial trends. Reviews and works aging reports. Compiles data and reports as requested by the Billing Director. Occasional driving to Outpatient clinics on an as-needed basis. High attention to detail and accuracy Ensures compliance with local, state, and federal government requirements. Performs other related duties as necessary or assigned. Experience in interpreting, communicating, and administering federal, state, and local laws, regulations, and policies involving the operation of programs and services for persons with mental health, intellectual disability, and substance use disorders. Bicultural competence of multiple cultural group

Minimum Qualifications:

Minimum high school diploma with emphasis on business-related courses. Thorough knowledge of billing practices and managed care requirements. Must have knowledge of CPT and ICD-10 codes. Working knowledge of behavioral health management practices and clinical operations. Bilingual Preferred (Spanish/English)

The Gándara Mental Health Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.