Government Billing Representative - Full Time, Days

Long Island Community Hospital has served this richly diverse region as a patient-first community hospital for more than 60 years. As Long Island's only independent community hospital, we are 100% committed to becoming the community's healthcare provider of choice with our greatly enhanced services including the Knapp Cardiac Care Center, our highly-advanced heart disease diagnosis and treatment facility, our new modern surgical pavilion, our unique ER approach, and our high-touch services including women's imaging, sleep laboratory and orthopedics and more. These services are delivered with the highest level of compassion by our LI Community Hospital staff - Long Islanders with an unmistakable mix of courage and heart who care about the people right here in our community and whose sole purpose is to provide personalized comfort. For more information, go to licommunityhospital.org, and interact with us on LinkedIn, Glassdoor, Indeed, Facebook, Twitter, YouTube and Instagram.

Position Summary:

We have an exciting opportunity to join our team as a Government Billing Representative - Full Time, Days - FIN-Rev Cyc Ops-Inpatient - Full-Time - 09:00.

In this role, the successful candidate Responsible for billing Medicaid County Vouchers In Patient Workers Compensation and In Patient No Fault insurance carriers Act as a responsible agent for the hospital to third party insurance carriers and patients Attend webinars/seminars and meetings Review and apply CMS and NYS DOH updates and changes in Medicaid Workers Compensation and No Fault regulations to billing processes Responsible to assist supervisor with various special projects Also responsible to assist with clerical tasks within the Business Office when needed

Job Responsibilities:

• Checks all inpatient Medicaid/County bills for accuracy in Epremis System prior to submission on a daily basis
• Write up County vouchers and send to County with UB04 claim
• Check all inpatient Workers Compensation/No Fault bills for accuracy in Epremis system prior to submission on a daily basis
• Utilizes patient information screens and checks notes for special billing Instructions prior to submission
• Review daily reports to request medical records for workers compensation/no fault cases via Stockamp Quic Lists
• Prepares inpatient Medicaid/Workers Compensation/No Fault claims for electronic and paper claims submission on a daily basis
• Makes sure all claims are accompanied by any applicable authorizations/precerts/referrals and medical records
• Review the Stockamp Quic lists mdash; for new Medicaid Workers Compensation and No Fault cases load the appropriate insurance plan codes and performs a rebill function in FMS For Medicaid cases verify the Medicaid coverage via EMEVS or Epaces prior to loading the Medicaid plan and performing the rebill function
• Performs various billing projects assigned by supervisor
• Checks all outpatient Medicaid/County bills for accuracy in Epremis system prior to submission on a daily basis
• Write up County Vouchers and send to County with UB04 claim
• Utilizes patient information screens and checks notes for special billing instructions prior to submission
• Corrects account information for accounts that appear on the error reports and performs rebills
• Prepares Medicaid claims for electronic submission on a daily basis
• Make sure all claims are accompanied by any applicable authorizations/precerts/referrals
• Reviews the Stockamp Quic list mdash; for new Medicaid cases loads the Medicaid insurance plan and performs a rebill function in FMS
• Reviews Stockamp STAT list for Inpatient Medicaid cases Checks claim status on Epaces and place notes in FMS If claim denied perform rebill to Medicaid if needed
• Reviews Stockamp STAT lists for Inpatient Workers Compensation/NoFault cases
• If accounts require follow up contact various carriers via phone for claim status i e CSC Out of State Medicaid carriers County WC and NF Carriers
• If any necessary changes are required; makes the changes to the claim and Epremis and re submits the corrected claim either electronically or via mail
• Brings problems accounts to the immediate attention of Governmental Coordinator or Supervisor
• Reviews Stockamp STAT lists for Out patient Medicaid cases Checks claims status on Epaces and place notes in FMS If claim denied perform rebill to Medicaid if needed
• If accounts require follow up contacts various carriers via phone for claim status i e CSC out of state Medicaid carriers County
• If any necessary changes are required: makes the changes to claim in Epremis and re submit the corrected claim either electronically or via mail
• Brings problem accounts to the immediate attention of Governmental Coordinator or Supervisor
• Updates all accounts with referral date for future follow up on a daily basis in Stockamp STAT lists
• If a denial is identified immediately enters denial reason as a comment in FMS moves the balances to appropriate payor and changes the financial class Moves account to appropriate Stockamp STAT list
• Enters 7M record in FMS to show current status of claim as a result of follow up i e insurance rep name approximate date of expected reimbursement
• Performs other duties as indicated by Supervisor
• Any correspondence received for Inpatient Medicaid Workers Compensation No Fault gets reviewed Information to be noted as 7M message in EMS Account to be followed up with phone call to insurance carrier
• Refers difficult or problematic correspondence to Governmental Coordinator Or Supervisor
• Any correspondence received for outpatient Medicaid gets reviewed information to be noted as 7M message in EMS account to be followed up with phone call to carrier
• Refers difficult or problematic correspondence to Governmental Coordinator or Supervisor
• Once an inlier payment received from carrier mdash; and accounts have been qualified for additional cost outlier monies requests the medical records and copies all info from imaging UB04 itemized bills copy of EOB medical records and cover sheet and places in Vendor box contacts vendor that a pick up is needed
• Handles mail from IPRO regarding cost outlier review mdash; identifies encounter # and copies IPRO letter and faxes letter to vendor handling the cost outlier billing
  
  

Minimum Qualifications:

To qualify you must have a High school diploma or equivalent Ability to use Microsoft Windows/ work in a Windows Environment Good organizational and analytical skills Must have the ability to concentrate and be detail oriented Ability to interpret reports and function in highly computerized environment Interpersonal and communication skills to interact with various personnel insurance carriers patients and agencies in both written and oral forms Ability to work independently and complete tasks and projects accurately and timely Ability to operate calculator and various office equipment Flexible to perform multiple tasks Knowledge of Medicaid Workers Compensation and No fault Facility Billing preferred

Qualified candidates must be able to effectively communicate with all levels of the organization.

Long Island Community Hospital provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

Long Island Community Hospital is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.

View Long Island Community Hospital's Equal Employment Opportunity (EEO) policy, the Federal "EEO is the law" poster, or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.

Long Island Community Hospital provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $52,942.50 - $52,942.50 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

View the Pay Transparency Notice for further details.