Third Party Billing Specialist

Community Healthcare Network Inc•New York, NY

5d•Onsite

About The Position

Community Healthcare Network (CHN) is a not-for-profit organization providing more than 65,000 New Yorkers with primary and behavioral healthcare, dental, nutrition, wellness, and needed support services. Our network is made up of 14 federally qualified health centers throughout Brooklyn, the Bronx, Queens, and Manhattan, along with a fleet of mobile vans that bring health services to underserved people in need throughout New York City. We provide judgment-free, high-quality healthcare, without regard to race, religion, orientation, gender identity, immigration status or ability to pay. We turn no one away.

Requirements

Associate degree or a satisfactory equivalent combination of education, training, and/or experience
Minimum of one (1) year of medical billing courses and/or one (1) year of experience with outpatient billing or a satisfactory equivalent, including knowledge of up-to-date CPT, ICD coding
Familiarity with computerized billing applications and spreadsheets
Manage care split claims
Knowledge of Federal and State reimbursement regulations
Ability to be flexible in a structured environment
Good interpersonal skills
Ability to communicate easily and display a cordial manner towards individuals from a variety of socio-economic, cultural, and religious background.

Responsibilities

Creates claims, scrubbing of claims for each Health Center Clinic site, and carefully code and correct each claim for submission daily
Performs daily verification by E-paces/Health plan provider portal and update patient profile, as needed
Effectively communicates with Health Center Clinic staff to revolve Level 1 billing issues.
Accurately checks Medicaid grid for Medicaid numbers and entering on patient profile
Weekly follow up on denied insurance claims, return mail and daily payor rejection errors
Follow up on refund requests
Post allowances to write-off bad debt
Follow up on pending FPBP Medicaid charges and enter Medicaid number for billing
Post payments from insurance companies and patients
Under the direction of supervisor, performs follow-up on all claims submitted, resolves disputed claims by gathering, verifying, and providing additional information
Using remittance report, return EOB’s for follow up on denied payments
Facilitates related services for health center patients and CHN staff as appropriate, with respect to their confidentiality and privacy
Performs other related duties, as assigned by supervisor