Description

Job Summary

We are looking for an experienced Medical Biller to join our dynamic team!

The individual in this role will be responsible for the processing of claims, posting payments to billing software to ensure that the Article 16 Clinic billing is accurate and compliant. Along with data analysis, in-depth evaluation and using sound judgement that claims are processed in a timely manner. The ideal candidate would have experience working in a non-for profit sector but we are also be willing to train the right individual who is highly organized and with a CAN DO ATTITUDE! If this position seems ideal and you are looking to grow in your professional career then we encourage YOU to APPLY!

Job Responsibilities

• Insurance verification
• Manage the clinic bill file between PCARE and MillinPro.
• Manage posting of claims and alerts into the MillinPro system promptly.
• Review claims for modifiers and send out to payers.
• Ensure patient insurance information is up to date in PCARE.
• Investigate and follow up on denied claims.
• Communicate with internal and external members.
• Report and aid problem accounts and insurance issues to Clinic Director.
• Maintain files of Explanation of Benefits (EOB).
• Organize payments and prepare check log for Fiscal.
• Maintain communication log to insurance companies.
• Post EOB's electronically/manually via Electronic Remittance Advice.
• Assist Clinic Director with clerical responsibilities.
• Participate in billing meetings with Sr. Accountant and Clinic Administration.
• Other miscellaneous billing related duties as assigned by Clinic Director.
• Undertake any task and initiative as assigned by the Clinic Director.

#INDHP

Qualifications

Qualifications

• Minimum High school diploma or GED.
• Minimum (1) year of experience as a Medical Biller.
• Excellent verbal, written and communication skills.
• Knowledge of billing codes when grouping services (groupers).
• Knowledge of APG (Ambulatory Patient Group) rates under DOH/OPWDD (Department of Health/Office of Persons with Developmental Disabilities).
• Ability to interpret crosswalk of rates between DOH/OPWDD.
• Solid organizational and detail oriented skills.
• Knowledge of Medicaid and Medicare regulations.
• Familiar with billing software and electronic medical records.
• Knowledge of eMedny/ePaces
• Must knowledgeable in Excel and be able to compile reports and spreadsheets.

Benefits 
What we offer once YOU join our growing family:

At HeartShare we offer a comprehensive benefit package based on full-time/part-time status. You can expect: 

• Paid time off (holidays, vacation in accordance with school calendar, sick and personal) 
• Professional development opportunities 
• Team environment 
• Medical and dental benefits 
• Employer-paid life insurance 
• Optional insurance (life, disability, etc.) 
• 403(B) retirement plans 
• Flexible spending account (dependent care, medical, parking, and transit).
• Employee assistance program 

HeartShare is an Equal Opportunity Employer (EOE). If you need to request accommodation during the recruiting process, please reach out to Leaves@heartshare.org. 

About HeartShare

Who WE ARE:
For over one hundred years, HeartShare has dedicated itself to improving the lives of people needing special services and support. The HeartShare team, now 2,100 employees and growing, helps individuals develop to their fullest potential and lead meaningful and enriched lives.
To learn more about HeartShare, please visit our website at www.heartshare.org or Follow us on Twitter LinkedIn YouTube Instagram Facebook
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