Billing and Accounts Receivable Specialist

Woods Services•Middletown Township, PA

About The Position

As a member of the Revenue Cycle Team, the Billing and Accounts Receivable Specialist is responsible for accurate and timely billing of services to Medicare, Managed Care, Medicaid, and Motor Vehicle claims. The role also includes posting payments, verifying authorizations, resolving claims, and following up on outstanding accounts receivable balances. The Woods organization supports children and adults with disabilities or challenges in achieving their highest potential and independence through innovative, individualized approaches that promote learning and personal fulfillment. Woods Services is a Pennsylvania and New Jersey-based nonprofit population health network and advocacy organization. Along with its six affiliates, it provides lifelong health, education, housing, workforce, behavioral health, and case management services to more than 22,000 people with complex medical and behavioral healthcare needs. Its Langhorne campus is home to 550 residents and provides outpatient and day programs.

Requirements

High school diploma required.
At least three years of work experience relevant to the position's duties and responsibilities.
Experience with billing in a healthcare environment required.
Strong interpersonal skills and a solid work ethic.
Excellent organization and communication skills.
Clerical and numerical proficiency.
Familiarity with Windows-based software application packages.
Ability to handle multiple tasks, meet established deadlines, and produce work that consistently meets or exceeds team benchmarks.

Nice To Haves

A high level of experience with Medicare, Pennsylvania Medicaid, Managed Care, and Third Party funders, including coordination of benefits.
Previous experience with computerized billing software and healthcare billing is strongly desired.

Responsibilities

Process and submit 837 electronic invoices and CMS-1500 and UB-92 claims and invoices to payers accurately and on time.
Verify insurance eligibility and use ICD diagnosis codes, CPT/HCPC codes, and modifiers to support accurate, timely payments.
Use knowledge of pre-certification and authorization processes to ensure certifications and authorizations are valid and accurate.
Enter and maintain authorizations in the Electronic Health Record.
Report authorization and eligibility information to the clinical team.
Ensure compliance with billing practices, policies, and procedures, including payer rules for Medical Assistance, Managed Care, Third Party, and Auto Liability.
Verify client eligibility and funding changes, and track and report changes that may affect reimbursement.
Submit claim corrections and resubmit invoices and claims when necessary.
Maintain client billing records.
Post payments accurately to appropriate client accounts in the billing system within five business days of receipt.
Identify and resolve unpaid claims and report issues to the supervisor.
Monitor weekly and monthly reporting on accounts receivable more than 30 days in arrears, including collection efforts and reimbursement issues.
Contact funders, clients, and guarantors by phone, email, and mail as part of collection efforts.
Provide exemplary customer service to external stakeholders and internal clients.
Collaborate with other departments and programs to gather and provide information about authorization and eligibility issues.
Maintain quality results by following established policies and procedures.
Share knowledge of current regulations, policies, and developments with team members and other stakeholders.
Maintain strict confidentiality of client information and adhere to HIPAA guidelines and regulations.
Demonstrate a strong commitment to performance accountability.
Respond to billing and account-related inquiries from funders and Woods management staff.
Attend relevant seminars and training sessions as specified by the Billing Supervisor or Revenue Cycle Manager.
Perform other duties assigned by the Billing Supervisor or Revenue Cycle Director.