Billing and Accounts Receivable Specialist

Woods Services•Middletown Township, PA

7d•$21•Onsite

About The Position

We want you to join our team! We need deeply compassionate, committed and highly talented staff. The Woods organization is guided by their mission to support children and adults with disabilities or challenges to achieve their highest potential and independence through innovative and individualized approaches that promote learning and personal fulfillment. Job Summary As a member of the Revenue Cycle Team, the Billing and Accounts Receivable Specialist is responsible for the accurate and timely billing of services, to Managed Care, Third Party, PA and NJ Medicaid and PA Wavier. Posting of payments, verification of authorizations, claims resolution and accounts receivable follow-up of outstanding balances.

Requirements

Education: Individuals with billing experience in a healthcare environment and a high school degree will be considered in lieu of a degree.
Experience: Minimum three years work experience relevant to the duties and responsibilities of the position required. A high level of experience with PA and NJ Medicaid, Managed Care and Third Party funders, including coordination of benefits. Previous experience with computerized billing software and healthcare billing strongly desired.
Other: Strong interpersonal skills and a solid work ethic. Excellent organization and communication skills, clerical and numerical proficiency and familiarity with Windows-based software application packages. Demonstrate the ability to handle multiple tasks, adhere to established deadlines, and produce work that consistently meets or exceeds team benchmarks.

Responsibilities

Verifies the accuracy and completeness of monthly and daily charges for tuition, residential and ancillary services.
Ensures timely, accurate and efficient processing and submission of all electronic 837 invoices and paper claims/invoices to Managed Care, PA and NJ Medicaid and PA Waiver for reimbursement.
Performs insurance coverage verification, correctly utilize ICD diagnosis codes, CPT/HCPC codes and modifiers to ensure accurate and timely payments.
Utilizes knowledge of the pre-certification and authorization process to ensure all certifications and authorizations are valid and accurate.
Enters and maintain authorizations in the Electronic Health Record.
Ensures compliance with billing practices, policies and procedures by leveraging strong knowledge of the policies and rules stipulated by Medical Assistance, State and Federal Waivers, Managed Care, Third Party, Auto Liability, Private Pay and various school districts.
Verifies client eligibility and funding changes.
Tracks and report residential changes that may impact reimbursement.
Timely submits claim corrections and resubmission of invoices and claims when necessary.
Maintains client and student billing records.
Accurately posts payments in the billing system to appropriate client accounts within five business days of receipt.
Identifies and resolves unpaid claims and report issues to supervisor.
Monitors weekly and monthly reporting on the status of accounts receivable over 30 days in arrears, provide details of collection efforts and issues with securing reimbursement.
Performs collection actions including contacting funders, clients and guarantors by phone, email, and mail.
Provides exemplary customer service to external stakeholders and internal clients.
Work collaboratively with other departments and programs to gather and provide information on authorization and eligibility issues.
Maintains quality results by following established policies and procedures.
Shares knowledge of current regulations, policies and developments with team members and other stakeholders.
Maintains strict confidentiality with regard to all client information. Adheres to all HIPAA guidelines/regulations.
Demonstrates a strong commitment to performance accountability.
Responds to inquiries from funders and Woods management staff regarding billing and account related matters.
Attends relevant seminars and training sessions to improve knowledge, skills and performance as specified by the Billing Supervisor or the Revenue Cycle Manager.
Other duties as assigned by the Billing Supervisor or the Revenue Cycle Manager.