Find & Apply For Billing Clerk / Specialist Jobs in York, South Carolina

The Billing Specialist will play a key role in managing billing tasks of MaxAbilities, including keeping financial records, preparing reports and updating financial information. The Billing Specialist Essential Job Duties include: 1. Service Provision Billing and Claims Management

• Coordinate with program staff to ensure that all billable units are properly captured and reported.
• Coordinate with program staff, families, and outside case management companies to maintain Medicaid eligibility.
• Coordinate with program staff to obtain and maintain payer information for services being provided by the Agency.
• Monitor service authorizations to ensure lapsing or other issues do not result in non-billable services.
• Prepare, review, and submit claims for services provided to customers through various payer sources, including State Funded services, Medicaid, private insurance carriers, managed care organizations, and other third-party payers.
• Ensure all billing is accurate, complete, and submitted within required filing deadlines.
• Analyze patient treatment records, check them for completeness/accuracy, and compile report of compliance concerns.

1. Other Billing and Revenue Collection Generate and process billing for room and board charges, customer fees, COBRA, work activity contracts, and any other organizational charges. Ensure room and board is properly charged for partial months of service. Coordinate with HR on COBRA billings and collections efforts. Coordinate with Adult Day Program staff on work activity billings and collections efforts. Maintain accurate customer account information and billing records. 2. Accounts Receivable and Payment Monitoring Communicate with customers, families, payers, and other responsible parties regarding account balances and payment arrangements. Consult with payers to review remittance advice and propose adjustments to Assistant CFO to any billings. Reconcile payments received from Medicaid, insurance carriers, and other payers. Investigate and resolve disputes, underpayments, denials, payment delays, and other discrepancies. Initiate appeals and corrective actions as necessary to maximize reimbursement. Initiate corrective action with others in the Agency to ensure future billing issues are resolved and prevented. Monitor accounts receivable aging and identify overdue accounts requiring follow-up. Initiate collections efforts either directly or through appropriate staff. Monitor outstanding balances and coordinate collection efforts to ensure timely payment. Propose write-offs to Assistant CFO of any uncollectible or erroneous amounts. 3. Analytical Review and Reporting Prepare monthly summary reports of Medicaid billing, adjustments, and revenue. Assist with developing and providing routine reporting on data analytics related to revenue cycle. Perform regular analytical reviews of billing activity, collections, reimbursement rates, denials, accounts receivable balances, and related revenue cycle metrics. Prepare reports and dashboards to identify trends, risks, and opportunities for improvement. Analyze payer performance and reimbursement issues affecting organizational revenue. Monitor key performance indicators related to billing and collections. Assist with audits and compliance reviews by providing requested documentation and analyses. 4. Communication and Collaboration Communicate all wage data to the Social Security Administration as required as a recipient of Supplemental Social Security Income (SSI). Maintain regular communication with the Assistant CFO regarding:

• Billing issues and processing concerns.
• Collection challenges and significant delinquent accounts.
• Claim denial trends and reimbursement issues.
• Results of analytical reviews and recommendations for corrective action.
• Emerging revenue cycle concerns that may impact organizational financial performance.

Collaborate with program staff and management to resolve billing and documentation deficiencies. Participate in process improvement initiatives related to billing, collections, and revenue cycle management.

Job Type:

Full-time Pay:

$24.00 - $31.00 per hour Expected hours: 40.0 per week

Benefits:

401(k) Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Vision insurance

Experience:

Medical Billers & Coders:

2 years (Preferred)

Work Location:

In person