Billing Clerk

BRISTOL AGING AND WELLNESS INC•Fall River, MA

15h•$0 - $22•Onsite

About The Position

This position is responsible for the revenue billing for the Senior Care Options (SCO) and One Care Insurance plans and acts as a liaison between the SCO and Finance Departments. The Billing Clerk will be responsible for the billing life cycle which includes processing claims, resolving exceptions, late billing, monitoring & rebilling claims, and ensuring compliance with company policies and industry standards.

Requirements

High School diploma or equivalent.
One to two years of billing experience.
Use of MassHealth 277, 837, 835 claims files preferred.
Experience with claims management system software preferred.
Intermediate computer skills.
Proficient in Microsoft Office Suite (Word, Excel, Outlook, & Teams).
Attention to detail and accuracy.
Ability to work independently and as part of a team.
Ability to prioritize.
Ability to multi-task and work in a fast-paced, high-volume environment.
Proven organizational and time management skills.
Good oral communication skills.
Driver’s license and reliable transportation are required.

Nice To Haves

Use of MassHealth 277, 837, 835 claims files.
Experience with claims management system software.

Responsibilities

Create, send, and track invoices for services rendered, using billing software.
Download POS billing claims from state database & upload claims into claims management software.
Submit required documentation to the health plans for reimbursement with case management, CDC, and training invoicing.
Provide finance with expected payments.
Ensure all uploads, 277, 999 and 835s received for submitted claims to Wellsky and documentation are saved in appropriate directory.
Review, adjust, and reprocess claims which are plan exceptions caused by manual error.
Resolve discrepancies, monitor issues related to claims and rebilling in a timely manner.
Maintain accuracy & compliance with HIPAA guidelines.
Prepare reports on required billing formats, billing activity, delinquency payments, and duplicate entries.
Collaborate with SCO team to ensure accurate billing, rosters, and timely collections.
Monitor unpaid or denied claims for outstanding or overdue payments to ensure billing is accurate.
Maintain up to date procedures.
Engage in online training to remain current with billing processes and procedures.
Cross-train and assist with accurate, timely vendor billing, and late billing.
Perform special projects, assignments, and tasks as assigned.