What are the responsibilities and job description for the Medical Billing & AP Specialist position at Covenant Case Management Services?
As a Medical Billing Specialist at Covenant Case Management Services, you will be responsible for overseeing the billing processes that are critical to our financial health and operational efficiency. This role requires a well-rounded understanding of both Accounts Payable (AP) and Accounts Receivable (AR) functions, with particular emphasis on Medicaid billing. Your expertise will ensure that claims are processed accurately and promptly, allowing us to focus on delivering quality services to our clients. This is a hybrid / remote role. Key Responsibilities : Medicaid Billing : Prepare, submit, and track claims for Medicaid services, ensuring compliance with state and federal regulations. Proactively monitor claims status and resolve any issues related to denials or rejections. Maintain up-to-date knowledge of Medicaid policies, billing codes, and reimbursement guidelines to ensure accuracy in claims submission. Conduct regular audits of billed services to ensure compliance and identify areas for improvement. Develop and maintain relationships with Medicaid representatives to facilitate effective communication and resolution of billing issues. Accounts Receivable : Manage the entire accounts receivable process, including invoicing, collections, and follow-up on outstanding payments. Communicate regularly with clients and insurers to address billing inquiries and payment discrepancies. Track and report on AR aging, analyzing trends and developing strategies to improve collection rates. Implement and maintain effective collection processes to minimize outstanding receivables. Accounts Payable : Process vendor invoices accurately and efficiently, ensuring timely payments and adherence to company policies. Verify the accuracy of AP transactions and maintain proper documentation for all purchases and payments. Assist in the preparation of monthly AP reports and reconciliation of accounts, ensuring that all expenditures are accounted for. Work collaboratively with vendors to resolve any discrepancies and maintain positive relationships. Financial Reporting : Generate detailed financial reports related to billing, collections, and revenue management on a monthly and quarterly basis. Analyze financial data to identify trends and provide insights that support business decision-making. Collaborate with the finance team to support budgeting and forecasting activities, ensuring alignment with organizational goals. Compliance and Documentation : Maintain accurate and organized records of all billing activities, communications, and financial transactions. Ensure adherence to all federal, state, and local regulations concerning billing practices and payments. Assist with internal and external audits by providing necessary documentation and responding to inquiries. Collaboration and Team Support : Work closely with case managers, administrative staff, and other team members to ensure accurate billing for services rendered to clients. Participate in team meetings to discuss billing processes, address challenges, and share best practices. Provide training and support to new staff members regarding billing processes and software. Continuous Improvement : Identify opportunities for process improvements within the billing department and propose solutions to enhance efficiency and accuracy. Stay current with industry trends, regulations, and best practices related to billing and accounts management. Participate in professional development opportunities to enhance skills and knowledge in billing and finance. Qualifications : Bachelor’s degree in Accounting, Finance, Business Administration, or a related field preferred or equivalent work experience. Minimum of 2-5 years of experience in billing, accounts payable, and accounts receivable, preferably within the healthcare or social services sector. Strong expertise in Medicaid billing processes, including knowledge of CPT / HCPCS coding and documentation requirements. Proficiency in billing software and Microsoft Office Suite (Excel, Word, Outlook); experience with electronic health record (EHR) systems is a plus. Excellent attention to detail and organizational skills, with the ability to manage multiple tasks and meet deadlines. Strong analytical and problem-solving abilities, with a commitment to accuracy and integrity. Effective communication and interpersonal skills, with the ability to collaborate with diverse stakeholders. Powered by JazzHR
