Remote US
About Nema:
Nema Health is a survivor and clinician-led virtual program for PTSD & trauma care. Our mission is to guide trauma survivors at every step of their journey towards healing, starting first with the remote, massed delivery of cognitive processing therapy (CPT).
Nema is seeking a full time coordinator to manage the day-to-day billing and revenue cycle management tasks for our growing business. The ideal candidate has extensive healthcare experience within healthcare billing and with payment practices. This person will act as a liaison between insurance companies, patients, and the Clinical Team to ensure accurate billing practices are executed with high quality. The Billing Coordinator is a member of the clinical operations department.
At Nema Health, we offer team members an unparalleled opportunity: each person can focus on Nema’s mission-driven goal while helping the business succeed through quality work. If you have experience working in billing, are highly organized, have strong communication skills, and would like to contribute to a meaningful mission, we invite you to apply.
Our Beliefs
- Diversity Drives Excellence: We believe that embracing diversity, equity, inclusion, and belonging is fundamental to our success, both in serving patients and fostering a culture of respect and compassion.
- Bring Joy To Work: We prioritize creating a positive and supportive work environment, celebrating successes, fostering a sense of humor, and providing emotional support for our team members.
Our Values
- Honor Through Impact: We genuinely impact people's lives by providing access to innovative PTSD therapies, always focusing on measurable improvements in patient health and well-being.
- Thoughtful Planning Enables Speed: We believe in thorough planning to ensure smart and sustainable decisions. After diligent consideration, we precisely and relentlessly implement our plans.
- Connect Through Compassionate Candor: We embrace open and compassionate communication, viewing tough conversations as opportunities for growth and continuous improvement.
- Character Over Credentials: We value qualities like hard work, integrity, and a willingness to learn more than just qualifications or titles, emphasizing the importance of team members' character.
- Live North Of Fair: We consistently do what's right, even when it's not the easiest path, and prioritize generosity, fairness, and transparency in all our actions, both inside and outside the company.
Primary responsibilities:
- Pre Authorization Management: Submit for pre authorizations when needed, maintain a record of who needs a pre authorization, submit renewals, and track tasks
- Claims Submission: Prepare and submit insurance claims for services provided with accuracy to minimize delays in payment, while adhering to insurance regulations and guidelines
- Billing Management: Monitor billing processes to ensure accuracy and completeness, identifying and rectifying any discrepancies or errors
- Claim Follow-Up: Follow up on unpaid or denied claims, identifying reasons for denials and taking necessary steps to resolve issues. Improve on our billing system to minimize future claim denials
- Payment Processing: Process payments received from insurance companies and patients, accurately recording transactions and reconciling accounts
- Collecting: Collect outstanding patient responsibilities following claim adjudication. Issue past-due notices for accounts with outstanding balances
- Documentation and Reporting: Maintain detailed records of billing activities, including claim submissions, payments, and denials. Generate reports as needed to track billing performance including monthly revenue reporting
- Communication and Coordination: Respond to inquiries from insurance companies, patients/families, and internal team members regarding billing and financial documents
- Compliance: Stay informed about changes in healthcare regulations and insurance policies to ensure compliance with billing procedures
Qualifications
Required
- 3+ years previous experience in medical billing and administrative roles interfacing with payers for functions such as eligibility verification and RCM
- Proficiency in billing software and electronic health records (EHR) systems
- Strong understanding of insurance policies, procedures, and billing codes
- Knowledge of third party payer reimbursement systems, rules and regulations relating to accounts receivable
- Excellent attention to detail and accuracy in data entry and record-keeping
- Sharp problem solving skills and ability to investigate and resolve discrepancies
- Positive, solution oriented attitude and comfort with ambiguity as Nema builds billing processes
- Effective communication skills, both written and verbal
- Comfort and familiarity working with spreadsheets and analyzing data
- Ability to work independently and manage time efficiently in a remote work environment
- High level of integrity and commitment to maintaining patient confidentiality
Preferred
- Telehealth billing experience, ideally across multiple states
- VBC or alternative payment model claims billing experience
- Specific experience with CMS 1500 claims
- Experience as a clinic or behavioral health facility billing specialist
- Experience working in a remote environment
- Accounting experience
- Coding/Billing Certificate from an accredited institute or school preferred
- Previous experience working in a health tech startup
- Passion for mental health and expanding access to treatment through insurance
