Logo
Partners For Quality

Billing Specialist - II

Partners For Quality, Robinson Township, Pennsylvania, United States

Save Job

Overview ORGANIZATION: Partners For Quality, Inc.

DEPARTMENT: Fiscal

POSITION: Billing Specialist - II

STATUS: Full Time; 37.5 hours/week

SCHEDULE / HOURS: Monday through Friday; 8:00 AM - 4:00 PM

LOCATION: Robinson Township

Partners For Quality Inc. (PFQ) is a private, non-profit organization based in Robinson Township. PFQ provides administrative management to five subsidiary organizations that support local individuals with intellectual & developmental disabilities and behavioral health challenges. PFQ’s management services include Fiscal (including payroll), HR, IT and Communications, enabling subsidiaries to focus on their day-to-day priorities.

Responsibilities Reports to the Revenue Cycle Director and/or Manager. Responsible for ensuring the accurate and timely processing of claims for PFQ’s family of agencies’ Mental & Behavioral Health and Intellectual Disabilities/Autism services. Monitor and respond to unpaid claims, denials and appeals to minimize days outstanding of accounts receivable. All responsibilities shall be completed in a manner consistent with Vision, Mission and Values of PFQ.

Prepare and submit invoices or claims to Medicaid, Medicare, private insurance, and other funding sources.

Verify client eligibility for services, when applicable.

Track and follow up on unpaid claims, denials, and appeals.

Work with programs to navigate and mitigate failed claims, develop reports, and share with program staff; track additional information as needed.

Troubleshoot and resolve complex billing systems.

Financial & Administrative Support

Maintain accurate records of billing transactions, payments, and outstanding balances.

Assist with reconciliation of accounts and resolve billing discrepancies.

Work with finance and program staff to ensure proper documentation for services rendered.

Respond to inquiries from clients, insurance companies, and internal staff regarding billing issues.

Prepare and maintain additional reports as requested.

Perform other related duties as assigned.

Compliance & Documentation

Ensure compliance with federal, state, and agency-specific billing regulations.

Keep up to date with changes in healthcare billing codes and payer policies.

Maintain confidentiality of client financial and personal information in accordance with HIPAA.

Understand and comply with PFQ Financial Policies and PFQ Corporate Personnel Policies and Procedures.

Benefits

Full-time employees enjoy a comprehensive benefits package:

Health, Dental and Vision Insurance

$1,200 cash payout option in lieu of Health Insurance coverage

Healthcare Flexible Spending Account

Dependent Care Flexible Spending Account

16 to 26 Paid Days Off per year

Wellness Days (2 per year)

Sick Time

8 Paid Holidays

Short Term Disability

Long Term Disability

Life Insurance

Optional 401(k) with Employer match

Work Perks

Paid orientation and training

Free parking (select locations)

Employee Activities, Rewards and Recognition Programs

Comprehensive Employee Assistance Program

Qualifications

Associate degree required or bachelor’s degree preferred

3-5 years’ experience in a human services agency in medical or social services billing, Medicaid/Medicare claims processing, or financial administration

Proficiency in Microsoft Excel & Word applications

Knowledge of medical billing software and/or electronic health records (EHR) systems

Strong attention to detail and problem-solving skills

Ability to work independently and as part of a team in a fast-paced environment

Valid Driver’s License and acceptable driving record

Act 33, 34 and FBI Clearances

Equal Opportunity Employer : Partners For Quality and its family of agencies are an equal opportunity employer. EOE

How to apply: Interested applicants can apply online or email resumes to Careers@PFQ.org

Note: This job posting reflects the current opening and responsibilities and is not a guarantee of employment.

#J-18808-Ljbffr