Billing & Medicaid Managed Care Liaison

Job Description

Job Description

Job Description Billing & Medicaid Managed Care Liaison

Job Overview of Billing & Medicaid Managed Care Liaison

The Billing and Medicaid Managed Care Liaison is responsible for the coordination of the billing and claiming process for the Office of Mental Health - Article 31 and, Children and Family Treatment Support Services (CFTSS), Office of Addiction Services and Supports - Article 32, and the Department of Health - Article 29i services. The Billing and Medicaid Managed Care Liaison directly ensures the coordination of health services for children enrolled in Article 29I and works collaboratively with Directors and Supervisors to support coordination of care in other programs. The Billing and Medicaid Managed Care Liaison makes sure Medicaid and Managed Care is verified for CFTSS & Article 29-I and checks eligibility for Committee on Special Education (CSE) placed youth and clinic clients. The Billing and Medicaid Managed Care Liaison confirms contract compliance and credentialing with insurance companies, including Single Case Agreements. The Billing and Medicaid Managed Care Liaison reports on collections and revenue as appropriate, maximizes revenue pertinent to enhance cash flow, ensures contract compliance and credentialing with insurance companies, and acts as a primary liaison with managed care organizations, program staff, and billing entities to ensure compliance and accuracy. The Billing and Medicaid Managed Care Liaison attends internal and external planning and status meetings as needed and provides exemplary customer service and presents a professional image.

Essential Duties of Billing & Medicaid Managed Care Liaison

Key duties of this position include, but are not limited to, the following :

• Serves as the liaison between finance and billing vendor and as the primary contact person for Medicare and Medicaid managed care and insurance companies.
• Coordinates health care services and benefits w / 29-I treatment team, MMCP's foster care liaison, Local Department of Social Services’ managed care foster care liaison, health care providers, & school and community-based services
• Interacts with clinical and billing staff and checks eligibility for public or private health insurance for CSE children and supports with checking eligibility for clinic clients as needed.
• Manage the billing process, voids, adjustment and collections as needed, reports weekly according to procedures to determine source, reasons, and resolution, and ensure issues are addressed in a timely manner.
• Assists with foster care placement changes, court-ordered services, and fair hearings for youth in Foster Care.
• Maintain up to date knowledge of billing regulations / requirements of Commercial insurance, Medicaid, Medicare, and Medicaid Managed Care pay sources and payor contract documents.
• Verifies that insurance company contracts, including changes to contracted services, are maintained and re-credentialed.
• Responsible for the closing and running of financial reports as appropriate, and ad-hoc reporting as needed.
• Maintains knowledge of OMH, OCFS, DOH, and OASAS regulations as well as agency policy and procedures and developments as they relate to administrative practice.
• Supports overall strategic plan for the organization.
• Ability to adhere to organization’s core values and commitments.

Essential Qualifications of Billing & Medicaid Managed Care Liaison

Key qualifications include :

Benefits of Billing & Medicaid Managed Care Liaison

Physical / Travel Requirements

Must have ability to reach, walk, sit, climb stairs, bend, lift, and be able to travel. Drivers preferred. required. The employee must be able to meet these requirements with or without a reasonable accommodation.

Disclaimer

Nothing in this job description restricts Andrus’ right to modify the duties / responsibilities of this job at any time, with or without advanced notice.

EEO Statement

Andrus is an equal opportunity employer.