Billing Manager Dart

COMMUNITY ACTION ORGANIZATION OF WESTERN NEW YORK INC•Buffalo, NY

8d•$65,000 - $70,000•Onsite

About The Position

This position is responsible for all revenue cycle management for the DART program ensuring timely, accurate, and compliant reimbursement for services incurred by patients and clients.

Requirements

Bachelor’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or related field, or equivalent experience.
Minimum of five (5) years of healthcare billing experience including Medicaid, Medicare, and commercial insurance
Minimum of two (2) years supervisory experience.
Strong commitment in maintaining confidentiality.
Proficient in Microsoft Office Suite
Proficient in billing software and electronic health record systems.
Strong knowledge of revenue cycle management, accounts receivable, billing regulations, and reimbursement processes.
Ability to communicate complex issues and advocate for the organization’s interests with external stakeholders such as insurance companies.
Excellent analytical, organizational, communication, and problem-solving skills.
Strong attention to detail.
Must be self-motivated and able to implement and maintain processes.
Ability to write reports and correspondence.
Ability to read and interpret documents such as medical billing procedures, operating and maintenance instructions, and procedure manuals.
Ability to perform computations rapidly and accurately, compile statistical reports, and apply concepts such as fractions, percentage, ratios, and proportions.
Strong understanding of the conventions of the medical coding system.
Working knowledge of CPT, HCPCS, and ICD-10 coding as applied to substance use disorder / OTP billing.
Familiarity with OASAS and NYS Medicaid billing portals, eMedNY, and clearinghouse claims systems.
Skilled in identifying, researching, and resolving claim denials, rejections, and underpayments.
Working knowledge of HIPAA privacy and security requirements and 42 CFR Part 2 confidentiality regulations for substance use treatment records.
Intermediate to advanced Excel skills (formulas, pivot tables, reconciliation workbooks) for tracking and reporting billing data.
Experience with electronic health record (EHR) and practice management systems, including configuration of billing and coding workflows.
Ability to interpret payer contracts and managed care agreements.
Strong vendor management skills, including monitoring outsourced billing performance against service-level expectations.
Effective leadership and staff development skills, including training non-billing staff on documentation requirements that affect reimbursement.
Requires patience and the ability to focus.
Must be able to read and write, speak and listen.
Frequently required to sit for prolonged periods of time.
Use of hands is required for tasks such as typing, writing, handling documents, and using office equipment.
Occasionally required to stand and walk.
Specific vision requirements include close vision, peripheral vision, and the ability to adjust focus.
Must be able to lift/move up to 25 pounds.
Valid NYS Driver’s License and proof of motor vehicle insurance coverage
Completion of the following documents: CAO Employment application, NYS SCR Clearance Form with acceptable clearance, Criminal Record Certification and free of criminal convictions of crimes against children (misdemeanor or felony), Fingerprinting required, Release for Reference Checks.

Nice To Haves

Experience in New York State substance use treatment billing, including opioid treatment program preferred.

Responsibilities

Oversee all revenue cycle processes including: Monitor and manage patient insurance eligibility, which includes assisting patients to obtain/recertify insurance. Monitor and manage provider credentials and report data to insurers. Act as a liaison with managed care organizations for contracting, credentialing, and issue resolution. Obtain authorizations and referrals for services rendered when required. Configure the electronic health record system and excel billing tools to identify and code clinical services for billing. Generate billing data. Submit claims accurately and timely. Manage accounts receivable and address claim denials and underpayments. Collect payments from clients. Reconcile payments between billing & claims and finance system.
Maintain understanding of NYS OASAS (Office of Addiction Services & Support), Medicaid, and insurance payer billing rules and regulations.
Develops, maintains, and implements policies and procedures for revenue cycle management.
Prepares billing and revenue reports and assists with month-end closing and audit reports.
Ensures compliance with confidentiality, billing regulations, and organizational policies.
Perform supervisor responsibilities by overseeing daily operations, recruiting, training, monitoring performance and ensure workplace policies and standards are followed.
Monitor and manage vendor performance.
Must present a professional image in conduct, attitude, and attire.
Satisfactory completion of mandatory trainings.
Additional duties as assigned.