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Form of workSalary: $19.23 - $20.05 per hour
Status: Non-Exempt, Part-Time, 32 hours weekly
Supervisor: Associate Director of Revenue Cycle Management
Position Summary:
The Billing Specialist is responsible for all aspects of claim payment and follow-up including payment application, denial management, appeals, re-billing, and waterfall billing. This position will require extensive communication with payers and between internal departments. Reports to the Associate Director of Revenue Cycle Management.
Job Requirements:
- High School diploma or GED.
- CPC License preferred.
- Minimum three (3) years' experience required in a medical-related environment and/or aptitude to understand medical billing and medical claim denial resolution based on prior work history.
- Previous Medicaid billing/EMEDNY preferred.
- Experience working with a diverse population preferred.
- Typing, data entry, general clerical and strong mathematical skills required.
Benefits:
- Medical, dental, and vision coverage.
- 403(b) retirement plan with employer match up to 5%.
- Generous paid vacation, holiday, sick and personal time package (2 weeks' vacation in first year, 13 paid holidays per year, 12 sick days per year and 4 personal days per year).
- Access to Family Services' Compassionate Leave Program where employees can donate/receive unused time off.
- Group term life and long-term disability insurance.
- Supplemental life insurance & accidental death and dismemberment coverage (AD&D).
- Supplemental insurance through Aflac.
- Employee assistance program (EAP).
- Pet insurance.
Our mission is to bring people together to find the support they need, improving their lives and communities, and building a stronger, safer Hudson Valley.
Our Agency Values
Integrity - Being honest and trustworthy
Compassion - Extending empathy and understanding to others
Hope - Believing in the strength of the human spirit and heart, to emerge and thrive in the face of challenge
Diversity - Promoting a vison of community comprised of wide-ranging assets
Respect - Treating all individuals with dignity and without judgement
Community - Recognizing and reinforcing the importance of our world as being comprised of people of differing strengths and perspectives
Justice - Promoting social and economic equity and fairness
Quality - Striving for excellence in every aspect of our work
Job Responsibilities:
- Review, post and fully reconcile all 3rd Party and client payments through 835 file upload and manual entry including all necessary accounting functions.
- Re-bill claims as needed and bill all payers in the waterfall process.
- Manage all 3rd party denials, identify trends, reporting and communicating with appropriate staff.
- Complete all levels of appeals adhering to the payer specific appeal requirements.
- Position requires extensive communication with 3rd party payers, clients, and staff.
- Respond to all 3rd party requests for information including refunds, medical records, provider, and client data.
- Examines claims, charges, and payments for compliance with agency, 3rd party and regulatory requirements.
- Provide regular periodic reports and updates on denials, unpaid accounts, payments, and any issues impacting revenue.
- Perform general billing duties including but not limited to reconciling billed services; remittance processing, insurance denial follow up, collections and communicating billing and insurance issues to appropriate staff.
- Effectively communicate with the vulnerable populations served by our agency as needed.
- Maintain current and accurate account information in the client and agency systems.
- Maintain current knowledge of all job specific requirements and related regulations.
- Self-Pay/Patient Statements on a bimonthly basis.
- Eligibility requests.
Competencies:
- Knowledge of Medical Terminology, CPT, HCPCS and lCD-10 coding.
- Knowledge of Netsmart/RevConnect and OMH reporting is a plus.
- Excellent documentation, verbal, and written communication skills.
- Knowledge of Microsoft Office; especially Excel.
- Attention to detail.
- General math skills.
- Knowledge of procedures and revenue cycle flow in a healthcare organization.
- Willingness to travel for agency business.
- Ability to learn and work within agency procedures and guidelines.
- Ability to exercise sound judgment in tracking sources of errors and in using established guidelines to determine the necessary corrective action.
#INDAD
We are an equal opportunity employer and our goal is to be a diverse workforce representative of the community we serve. Family Services, Inc. follows federal, state, and local laws prohibiting discrimination in hiring and employment. We do not discriminate against employees or applicants in violation of those laws.
