Billing specialist

JOB DEFINITION :

Senior Billing Specialist II primary responsibilities are Billing / Claims Submission, Provider Enrollment & Credentialing, Payment Posting and Account Receivable follow-up.

This position is fully remote.

EDUCATION AND EXPERIENCE :

• High School diploma or equivalent
• 5 years' experience in Full Revenue Cycle Operations in a Healthcare setting.
• Solid Knowledge and understanding of Billing Concepts, ICD-10, Medical Terminology, Behavioral Health Billing, and Electronic Medical Records.

Ability to read and understand EOBs.

• Must have the ability to multitask and manage time effectively.
• Effective written and verbal communication skills.
• Proficient in Microsoft Office - Excel and Word.

DUTIES AND RESPONSIBILITIES :

• Review, post and fully reconcile all 3rd Party Payer and Client payments through 835 file upload and manual entry including all necessary accounting functions
• Review and process rejected claims; analyze rejection reasons to assist in avoiding future rejections
• Works in all phases of provider enrollment, re-enrollment and expiration management to ensure the timely and accurate enrollment (and recredentialing) of providers in commercial & government payers.
• Responsible for maintaining copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.

As well as track all state license, DEA, and board certification expirations for all providers to ensure timely renewals.

• Responsible for generating 3rd Party Payer claims and ensuring timely submission through use of electronic billing software, clearinghouse, payer portals and paper claims
• Add, update and maintain accurate payer and fee schedule setup in electronic billing software
• Run Insurance Eligibility Batches and distribute Reports to all Programs.
• Monitor Aging Reports (AR) and perform extensive and timely account follow-up activities. To investigate, analyze, appeal and resolve any denied insurance claims
• Routinely contacts insurance companies to follow-up unpaid claims. In addition, utilizes Insurance Portals to pull or review EOBs
• Complete all levels of appeals, adhering to payer specific appeal requirements
• Analyze Denial reasons, identify trends to avoid future denials
• Run Insurance Verification / Eligibility as needed.
• Collect and Review Referrals / Authorizations as needed.
• Review all client / patient information, to make sure it matches what's in the Billing System before submitting claim to insurance companies.
• Effective communication with clients and staff to resolve billing inquiries and issues
• Identify and implement quality improvement trainings and activities as part of professional development goals
• Complete QI Training during onboarding and participate in QI refresher training as needed.
• Ability to cultivate a culture of inclusion for all employees that respects their individual strengths, views and experiences.

A Culture that makes better decisions, drives innovation, and delivers better business results.

• Adherence to all safety protocols and procedures to ensure a safe working environment for all employees. Demonstrate a commitment to maintaining a safe work environment by following established safety guidelines.
• Health and Safety Awareness : Include any relevant knowledge or experience regarding health and safety protocols to ensure a safe work environment for all employees.
• Be able to attend agency functions onsite, included but not limited to agency fundraising events and Staff Day.
• Other duties as assigned.

BENEFITS :

We offer an attractive and competitive benefits package for full time employees which includes but not limited to :

• Medical
• Dental
• Vision
• $0 Deductible Platinum Plus Medical Insurance Plan - 90% Employer Provided Benefit
• Flexible Spending Account
• 403(b) retirement plan
• Long Term and Short Term Disability
• Legal Plan
• Dependent Care Expense Account
• Life Insurance / Supplemental Life Insurance
• Pet Insurance
• Training programs including a Mentorship program
• Employees may be eligible for Federal / Public Student Loan Forgiveness
• Career growth and Promotional opportunities
• Employee Perks and Discounts to Broadway shows and more

5 Personal Days, 10-20 Vacation Days, 12 Sick Days, 12 Company Paid Holidays-yearly and so much more.

CN Guidance & Counseling Services , inspires and catalyzes recovery for people living with mental health and substance use conditions through innovative and person-centered integrated clinical treatment, counseling, housing, and support services.

• Awarded Newsday / Dan papers Top Long Island Work Place 2019-2023, 5 years in a row.
• Every job and every team at our agency plays a role in helping other Long Islanders live healthy and fulfilling lives.
• Engage your passion and CHOOSE a career & employer where you can use your vital energy to make a difference.

It is the policy of CN Guidance and Counseling Services, Inc. to ensure equal employment opportunity without discrimination or harassment on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, age, disability, marital status, citizenship, national origin, genetic information, or any other characteristic protected by law.

Last updated : 2024-08-20

Salary : $22 - $27