Medical Biller

GENERAL DESCRIPTION:

This role involves preparing Medicaid and other third-party insurance claims, using sound judgment within the billing office. The Billing Specialist provides guidance to staff on billing procedures, regulations, and the computerized billing system, ensuring accurate and detailed billing and accounts receivable records are maintained. Additionally, the A/R Billing Specialist supports the Assistant Director of Fiscal Services in generating monthly revenue and accounts receivable reports.

PRIMARY DUTIES AND RESPONSIBILITIES:

Claims Processing: Submits Medicaid, third-party insurance, and other funding source billings for all program services daily/weekly to meet financial processing deadlines. Offers guidance to staff on billing procedures and coordinates system updates. Tracks and reconciles billable units by program monthly through checklists/worksheets.

Submits bi-weekly billings for Medicaid transportation, monthly for third-party transportation, and rent invoicing.

Communication: Collaborates with Directors and service staff to provide backup billing documentation, address questions, ensure proper data entry, implement new procedures or regulatory changes, and uphold Corporate Compliance standards. Attends quarterly meetings to review billing issues.

Cash Collection: Ensures timely and accurate billing processing to maximize cash flow. Oversees third-party insurance claim collections, self-payment accounts, and other open receivables. Posts cash to the open receivable report and assists staff with cash posting and effective collection methods.

Denial Follow-up: Follows up on denied third-party insurance claims and supports others in doing the same. Coordinates collection efforts for difficult accounts and, if needed, recommends using an external collection agent to the Sr. Director of Fiscal Services.

Record Keeping: Organizes and maintains detailed records for all billings, monthly income receipts, and accounts receivable by program area.

Reporting: Assists the Sr. Director of Fiscal Services with monthly and annual A/R and G/L reports, special analyses, and audit preparation. Provides resources for auditors by explaining billing procedures and processes. Generates reports for monthly Quality Control audits.

Problem Solving: Communicates with Medicaid and third-party insurance representatives to resolve claims processing issues (including clinic billing via SAMCI). Collaborates with the Information Services department and billing software vendors to troubleshoot problems.

Special Projects: Participates in special projects as assigned.

Job Type: Full-time

Pay: $22.00 - $26.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Medical billing: 3 years (Required)
• Medicare: 3 years (Required)
• Accounts receivable: 3 years (Required)
• Medicaid: 3 years (Required)

Ability to Commute:

• Waterloo, NY 13165 (Required)

Ability to Relocate:

• Waterloo, NY 13165: Relocate before starting work (Required)

Work Location: Hybrid remote in Waterloo, NY 13165

Salary : $22 - $26