Billing Specialist

Location: Corona, Queens, NY
Schedule: Monday–Friday, 10:00 AM–6:00 PM, Full-Time
Salary: 55K Annually
Reports To: Billing Manager

Position Summary

The Billing Specialist is responsible for accurate and timely billing, claim follow up, denial resolution, self-pay financial assessments, and payment follow up for Medicaid, Medicare, managed care, commercial insurances and self-pay services using InSync by Qualifacts and the Inovalon clearinghouse.

Essential Duties & Responsibilities

Core duties and responsibilities include the following. Other duties may be assigned as needed.

Verify participant’s eligibility for Medicaid, Medicare and private insurances
Process Insurance payments to participant accounts in computerized system.
Make sure all participants are pre certified, pre authorized, and authorization for participant SUD billing.
Submit accurate electronic claims through InSync and Inovalon, the agency’s clearinghouse.
Researches rejected, denied and unpaid claims; completes corrections, resubmissions, appeals and payer follow-up through resolution.
Reviews remittance and payment information and identifies underpayments, recoupments, missing payments and posting discrepancies
Responds to participant billing and statement inquiries.
Makes recommendations to management for write-offs.
Handles appeals and follow-up for managed care and out-of-network claims.
Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully.
Conducts financial assessments for self-pay participants in accordance with agency policies and established fee schedules.
Explains self-pay responsibilities, payment expectations and available payment arrangements to participants.
Monitors self-pay balances and follows up with participants regarding outstanding payments and agreed-upon payment plans.
Maintains accurate documentation of financial assessments, payment arrangements, and participant communication and collection activity.
Escalates delinquent accounts and recommends appropriate next steps to the Billing Manager.
Works assigned A/R by age and timely-filing risk; documents all billing activity and follow-up dates; maintains billing and collection trackers; escalates unresolved barriers to the Billing Manager.

Qualifications

Bachelor’s degree or existing staff with over 5 years of experience.
Knowledge of billing software, (Preferably EPACES, Insync and Inolvalon)
Attention to detail
Good record keeping skills, outstanding communication skills and excellent interpersonal skills
Must have computer skills.

Other Skills & Abilities

Researches rejected, denied and unpaid claims; completes corrections, resubmissions, appeals and payer follow-up through resolution.
Excellent judgment and discretion; ability to handle multiple priorities simultaneously, meet deadlines, and handle work-related stress is required.
Friendly, courteous, service-oriented, professional, outgoing, and customer service oriented.
Detail oriented while maintaining an extremely positive attitude.
Must be able to work independently and productively with minimum supervision.
Recognize problems, identify possible causes and resolve routine problems.
Team player with a "can do" attitude that can work in a fast-paced environment.
Ability to establish and maintain professional atmosphere for employees, participants and customers

Benefits

15 Vacation Days annually
12 Sick Days annually
1 Floating Holiday annually
401(k) Retirement Plan with 3% employer match after 90 days of employment
Medical Insurance through Cigna after 30 days of employment
Dental & Vision Insurance eligibility after 90 days
Access to Gym/Weight Room
Access to Boxing Ring
Short-Term Disability
Life & Accidental Insurance available through Aflac
TransitChek for commuting expenses
LegalShield legal services
Potential eligibility for Public Service Loan Forgiveness (PSLF) for qualifying employees and employment

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Pay: $55,000.00 per year

Benefits:

401(k) matching
Dental insurance
Health insurance
Paid time off
Retirement plan
Vision insurance

Education:

Bachelor's (Preferred)

Experience:

Medical billing: 5 years (Required)

Ability to Commute:

Corona, NY 11368 (Required)

Work Location: In person

Noble Hearts HR Consulting

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Billing Specialist