Title: Billing Specialist

Salary: $21.00/hr

Status: Temporary, Part-Time, Non-Exempt 

Reports to: AD of Revenue Cycle Management

Schedule: Monday – Friday, 4 hours per day (20 hours total)

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. Ability to work self-sufficiently on assigned projects to aid in Billing system upgrade.

Position Qualifications:

• 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.
• Typing, data entry, general clerical and strong mathematical skills required.
• Experience in working within Netsmart Finance NX and integrated clearinghouse with successful electronic claims processing.
• Previous Medicaid billing/EMEDNY preferred.
• Experience working with a diverse population preferred.

Position Responsibilities:

• Review, post, and fully reconcile all 3^rd 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 3^rd 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 3^rd party payers, clients, and staff.
• Respond to all 3^rd party requests for information including refunds, medical records, provider, and client data.
• Examines claims, charges, and payments for compliance with agency, 3^rd 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 and responses, communication with other departments on terminations and eligibility.

Competencies:

• Knowledge of Medical Terminology, CPT, HCPCS and lCD-10 coding.
• Knowledge of Netsmart/ RevConnect and OMH reporting is a must.
• Excellent documentation, verbal, and written communication skills
• Knowledge of Microsoft Office; especially MS 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.

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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.