Organization Overview:

Founded in 1972, The Door empowers educationally and economically disadvantaged youth to reach their potential by providing a complete range of services all under one roof. Each year young people from all five New York City boroughs come to The Door for primary health care, reproductive care and health education, dental services, eye care services, mental health counseling, legal services, supportive housing, career & education services, daily meals, cultural arts and services.

Position Overview:

The Billing Specialist is an integral part of the health center team and assists with generating revenue for the health center. The incumbent should possess great interpersonal communication and exceptional organizational skills. The primary goal is to ensure compliance, timely and accurate management of all claim submissions to maximize revenue.

Responsibilities:

• Perform all duties in a timely and efficient manner to ensure the completeness and accuracy of all claims to facilitate maximum reimbursement. 
• Perform follow-up activities by working Aging and outstanding accounts/AR using effective follow-up methods such as insurance company web portals, phone calls, etc.to ensure timely reimbursement 
• Identify trends and perform root-cause analyses to resolve registration, claim submission and utilization management discrepancies
• Accurately post and manage all payment posting related activities and submit appropriate claims to Medicaid for supplemental and shortfall payments.
• Utilizes all resources available to verify eligibility and claim status and meets departmental productivity and quality assurance standards.
• Reviews and resolves denials and rejections in a timely manner to increase revenue
• Ensure compliance with all State, Federal and Third-Party Payer policies and regulations.
• Documents clearly in the billing system the claim issue and course of action taken on every account worked. Documentation and action must be clearly noted for future follow up and review.
• Updates demographic and insurance information and verifying eligibility as needed. Sort and manage correspondence as needed
• Handles patient inquiries and answers billing questions from staff members and insurance carriers
• Participates in patient-centered medical home care team collaboration, including team huddles.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Perform other related tasks, as assigned by the supervisor to meet the needs of the department and organization 

Qualifications:

• Associates Degree preferred and/or billing or coding certification preferred. High School Diploma or HSE required. 
• At least two years of medical billing including experience with Third-Party payers required.
• Ability to understand and communicate insurance benefits explanations, exclusions, denials, and payer adjudication process.
• Demonstrated experience with electronic health records (preferably eClinicalWorks) 
• Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
• Excellent written and oral communication skills a must; ability to establish good rapport with patients and staff.
• Ability to organize and manage concurrent projects, multitask and manage time effectively while performing well under pressure.
• The ideal candidate is a motivated individual with a positive attitude and exceptional work ethic.
• Ability to work independently or as part of a team in a fast-paced environment.
• Bilingual English/Spanish a plus.