Billing Liaison

Family Services Inc. • Poughkeepsie, NY

1d • $20 - $21 • Hybrid

About The Position

The Billing Liaison is responsible for all aspects of claim payment and follow-up including payment application, denial management, appeals, re-billing and waterfall billing. This position will require extensive communication with payers and between internal departments.

Requirements

• High School diploma or GED, CPC License preferred
• Minimum three (3) years’ experience required in a medical-related environment and/or aptitude to understand medical billing and medical claim denial resolution based on prior work history. Previous Medicaid billing/EMEDNY preferred. Experience working with a diverse population preferred.
• Typing, data entry, general clerical and strong mathematical skills required.
• Attention to detail
• General math skills
• Knowledge of procedures and revenue cycle flow in a healthcare organization.
• Willingness to travel for agency business.
• Ability to learn and work within agency procedures and guidelines.
• Ability to exercise sound judgment in tracking sources of errors and in using established guidelines to determine the necessary corrective action.
• Position requires extensive communication with 3rd party payers, clients and staff
• Knowledge of Medical Terminology, CPT, HCPCS and lCD-10 coding.
• Knowledge of Netsmart/ RevConnect and OMH reporting is a plus
• Excellent documentation, verbal and written communication skills
• Knowledge of Microsoft Office; especially EXCEL
• Must be authorized to work in the United States without work sponsorship.

Responsibilities

• Perform initial and ongoing insurance eligibility and benefits verification for all payers including Medicaid, Medicare, Medicaid Managed Care, Medicare Advantage Plans, Commercial Insurance, Workers Compensation, No Fault and others as needed utilizing 270/271 Files, payer portals and telephone.
• Enter and maintain all client insurance assignments and account information in EHR/EMR in an accurate and timely manner.
• Accurately identify and document client costs including deductible, copays, co-insurance and non-covered services.
• Communicate with clients, front desk staff and clinical staff regarding client costs and document any issues.
• Assign sliding scale fees according to company policy through document and income verification, formulate payment arrangements and assist client with referral to Insurance Navigator if applicable.
• Communicate with Local Departments of Social Services regarding client Medicaid eligibility including spending down, restrictions, retrospective eligibility review and coverage.
• Complete insurance pre-certifications on required services and assist in completing insurance paperwork as needed.
• Generate, review, and distribute client statements.
• Review, follow-up and collect any unpaid patient accounts or request refunds for credits and communicate any issues with appropriate staff.
• Regular onsite availability at all clinic locations for client and staff billing needs.
• Answers telephone regarding internal and external billing inquiries.
• Assists with reviewing, posting and adjusting patient payments into the billing system.
• Alerts the appropriate staff of any potential barriers (anticipated insurance, financial issues, etc.).
• Works closely with Finance/Billing/Collection department.
• Enters benefit assignments.
• Uploads the Verification of Benefits
• Also places in the Share drive Benefits folder to ensure audit trail.
• Insurance Card
• Completes Financial Data Sheet, reviews with clients, and communicates information to Billing Department.
• Upload the FDS into Benefit Assignment
• Add alerts Information to include, but not limited to co-pays, deductibles, fee schedules, policies, etc.
• Deactivate alerts when necessary.

Benefits

• Medical, dental and vision coverage.
• 403(b) retirement plan with employer match up to 5%.
• Generous paid vacation, holiday, sick and personal time package (2 weeks’ vacation to start, thirteen (13) paid holidays per year, twelve (12) sick days per year and 4 personal days per year).
• Group term life and long-term disability insurance.
• Supplemental life insurance & accidental death and dismemberment coverage (AD&D).
• Supplemental insurance through Aflac.
• Employee assistance program (EAP).
• Access to Family Services’ Compassionate Leave Program where employees can donate/receive unused time off.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees