What are the responsibilities and job description for the Billing Specialist - Billing position at The Bridge?
The Bridge offers supportive housing and behavioral health services to vulnerable New Yorkers facing behavioral health and substance use challenges. We provide individuals with the tools they need to pursue their dreams and live meaningful lives. The Bridge envisions a world where adults experiencing serious mental illness can live and thrive within their communities. As a recognized leader in developing and operating supportive housing and community-based programs, The Bridge has 70 years of experience helping New Yorkers with mental illness, including those affected by homelessness, incarceration, and institutionalization.
Scope of Position: The Medical Billing and Collections Specialist is responsible for ensuring accurate, timely, and compliant billing and collections activities across a comprehensive range of services. This role prepares and submits electronic claims, monitors claim status, researches and resolves rejections and denials, documents account activity, and posts payments and adjustments. The Specialist works with Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers to support accurate reimbursement while maintaining compliance with applicable billing and regulatory requirements.
Essential Position Functions
Scope of Position: The Medical Billing and Collections Specialist is responsible for ensuring accurate, timely, and compliant billing and collections activities across a comprehensive range of services. This role prepares and submits electronic claims, monitors claim status, researches and resolves rejections and denials, documents account activity, and posts payments and adjustments. The Specialist works with Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers to support accurate reimbursement while maintaining compliance with applicable billing and regulatory requirements.
Essential Position Functions
- Prepare, review, and transmit claims using billing software and claim processing systems.
- Correct, complete, and process claims for all payer codes.
- Collaborate with programs to ensure accurate billing and resolve discrepancies.
- Assist with reconciling billing audit-related information.
- Generate and review billing service reports from the EHR and billing software.
- Follow up with programs regarding eligibility issues.
- Perform charge and payment entry within the EHR.
- Coordinate with providers to clarify incomplete or missing information needed for proper account and claim adjudication.
- Follow up with Medicare, Medicaid, Managed Care Plans, and commercial insurance companies on unpaid insurance accounts identified through aging reports.
- Process appeals through online platforms or paper submission.
- Attend provider and program meetings as needed.
- Communicate with billing and credentialing specialists to identify and resolve issues.
- Process billing calls and respond to inquiries from third-party carriers.
- Respond to correspondence related to payment recovery and audit accounts.
- Identify trends and payer-related issues affecting billing and reimbursement.
- Perform other duties as assigned.
- Associate’s degree in Healthcare Administration, Health Information Management, or a related field from an accredited college required; a certificate from a medical billing technical school is a plus. Certified Professional Biller (CPB) and Certified Professional Coder (CPC) credentials are also a plus.
- Three (3) to five (5) years of healthcare billing experience, including knowledge of Medicaid, Managed Care, and Medicare billing and payment procedures.
- Knowledge of OMH and OASAS regulations and procedures.
- Knowledge of New York State (NYS), Centers for Medicare & Medicaid Services (CMS), and Managed Care billing and payment regulations.
- Strong interpersonal skills with the ability to communicate effectively and resolve billing-related issues.
- Strong research and analytical skills.
- Ability to work independently.