Access: Supports for Living
Overview
Senior Billing Specialist role at Access: Supports for Living – Middletown, NY.
Location: Middletown, NY
Pay Rate: $26.44 per hour
Hours: Monday-Friday 8:00 AM-4:30 PM (40 hrs)
Reporting to the A/R Manager, the Senior Billing Specialist is a key position in the financial management of the company. The Senior Billing Specialist supports all billing and revenue management throughout the revenue cycle. This individual manages the electronic claims process, including accurate and timely claim batch creation, submission, and uploading of claims with providers and insurance companies, including but not limited to daily procedure review, self-pay and co-payment processing, ensuring payments related to participant services from all sources are recorded and reconciled timely in order to maximize revenues. Additionally, the Senior Billing Specialist will assist Finance in maintaining the financial data required for revenue management report generation, and assist with credentialing management and regulatory audits.
Duties / Responsibilities
Promote revenue cycle improvements throughout the organization, including working with appropriate programs, front desk staff, remit, denial management and insurance verifications areas to aid in the resolution of identified revenue cycle billing issues
Handling billing cycle review procedures for pre-processing (scrubbing) of weekly claims processing
Analyze, billing and processing program claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues
Analyzing, identifying and resolving complex claims issues adversely impacting the revenue cycle management and billing process and achieving resolution through coordination and reconciliation
Review and work claims in the clearinghouse & Fund EZ. Complete weekly billing batches (uploads and response files) in Electronic Health Record (MyEvolv)
Understand clients’ insurance benefits utilizing ePACES, various payers’ portals.
Maintain a working knowledge of OMH, OASAS, Medicare, Medicaid, Medicaid Managed Care and other payers’ billing regulations for all programs.
Understand and remain updated with current coding and billing regulations and compliance requirements
Oversight of self-pay processing and assist with monitoring on participant outstanding balances
Provide credentialing management support working with program directors to identify when changes must be made to the EHR system, incudes communicating to systems support when corrections require a process or system change.
Cross-train other revenue cycle areas to support and back-up the remit and denial management functional areas
Qualifications
An Associate Degree from an accredited university with accounting degree preferred
Detail-oriented, and able to work independently as well as on a collaborative team.
Knowledge of Medical Insurance programs such as Medicaid, Medicare and Dual eligibility benefits establishment.
Experience with automated billing systems and familiarity with regulatory and compliance requirements and statutes
Knowledge and experience with behavioral health/medical billing (Strong preference is given to candidates who have attended an accredited certificate program focused on Medical Billing).
Ease and comfort with numbers and calculations
Working knowledge of related CPT Codes and Revenue Codes
Excellent written and verbal communication skills, as well as excellent organizational and interpersonal skills.
Ability to take initiative and problem-solving skills.
Capable of setting priorities and ability to manage multiple projects as well as strong follow-through skills.
Ability to communicate effectively with all levels of employees, including leadership as required.
Proficient working with Word, Excel, PowerPoint and Electronic Medical Record Systems (MyEvolv is a plus).
Work Environment and Physical Demands
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Physical Demands
This is largely a sedentary role; however, some filing is required. This would require the ability to move files, open filing cabinets and bend or stand, as necessary.
EEO Employer
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Accounting/Auditing and Finance
Industries
Non-profit Organizations
#J-18808-Ljbffr
Location: Middletown, NY
Pay Rate: $26.44 per hour
Hours: Monday-Friday 8:00 AM-4:30 PM (40 hrs)
Reporting to the A/R Manager, the Senior Billing Specialist is a key position in the financial management of the company. The Senior Billing Specialist supports all billing and revenue management throughout the revenue cycle. This individual manages the electronic claims process, including accurate and timely claim batch creation, submission, and uploading of claims with providers and insurance companies, including but not limited to daily procedure review, self-pay and co-payment processing, ensuring payments related to participant services from all sources are recorded and reconciled timely in order to maximize revenues. Additionally, the Senior Billing Specialist will assist Finance in maintaining the financial data required for revenue management report generation, and assist with credentialing management and regulatory audits.
Duties / Responsibilities
Promote revenue cycle improvements throughout the organization, including working with appropriate programs, front desk staff, remit, denial management and insurance verifications areas to aid in the resolution of identified revenue cycle billing issues
Handling billing cycle review procedures for pre-processing (scrubbing) of weekly claims processing
Analyze, billing and processing program claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues
Analyzing, identifying and resolving complex claims issues adversely impacting the revenue cycle management and billing process and achieving resolution through coordination and reconciliation
Review and work claims in the clearinghouse & Fund EZ. Complete weekly billing batches (uploads and response files) in Electronic Health Record (MyEvolv)
Understand clients’ insurance benefits utilizing ePACES, various payers’ portals.
Maintain a working knowledge of OMH, OASAS, Medicare, Medicaid, Medicaid Managed Care and other payers’ billing regulations for all programs.
Understand and remain updated with current coding and billing regulations and compliance requirements
Oversight of self-pay processing and assist with monitoring on participant outstanding balances
Provide credentialing management support working with program directors to identify when changes must be made to the EHR system, incudes communicating to systems support when corrections require a process or system change.
Cross-train other revenue cycle areas to support and back-up the remit and denial management functional areas
Qualifications
An Associate Degree from an accredited university with accounting degree preferred
Detail-oriented, and able to work independently as well as on a collaborative team.
Knowledge of Medical Insurance programs such as Medicaid, Medicare and Dual eligibility benefits establishment.
Experience with automated billing systems and familiarity with regulatory and compliance requirements and statutes
Knowledge and experience with behavioral health/medical billing (Strong preference is given to candidates who have attended an accredited certificate program focused on Medical Billing).
Ease and comfort with numbers and calculations
Working knowledge of related CPT Codes and Revenue Codes
Excellent written and verbal communication skills, as well as excellent organizational and interpersonal skills.
Ability to take initiative and problem-solving skills.
Capable of setting priorities and ability to manage multiple projects as well as strong follow-through skills.
Ability to communicate effectively with all levels of employees, including leadership as required.
Proficient working with Word, Excel, PowerPoint and Electronic Medical Record Systems (MyEvolv is a plus).
Work Environment and Physical Demands
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Physical Demands
This is largely a sedentary role; however, some filing is required. This would require the ability to move files, open filing cabinets and bend or stand, as necessary.
EEO Employer
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Accounting/Auditing and Finance
Industries
Non-profit Organizations
#J-18808-Ljbffr