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Billing Specialist - Rochester



Employment Type: Full-Time
Summary:
The Billing Specialist will be responsible for coordinating with various insurance companies to bill claims, resolve unpaid/denied claims and will ensure timely and full collection of revenues. Billing is done directly with Medicaid and insurance companies under Managed Long-Term Care (MLTC) Plans, or with private pay contracts. This role reports to the Billing Manager.
Duties:
  • Collaborates closely with various insurance companies to proactively address unpaid or denied claims, striving for full collection of revenues.

  • Implement effective strategies to resolve claim disputes and discrepancies, ensuring maximum reimbursement for services provided. Generates rebills and adjustment billing promptly and with exceptional accuracy, adhering to industry standards and regulations.

  • Continuously monitor and assess billing records to identify opportunities for adjustments and corrections as needed.

  • Utilize comprehensive documentation, reference materials, and payer websites to process claims with precision and efficiency.

  • Stay updated on the latest billing and coding guidelines to ensure claims meet compliance standards.

  • Play a pivotal role in addressing front-end rejections by working closely with clearing houses to resolve issues promptly, minimizing billing delays.

  • Proactively reconcile and resolve billing discrepancies, ensuring that all financial data is accurate and in alignment with organizational standards.

  • Accurately post payment remittances and generate detailed reports, facilitating transparency in financial transactions and aiding in financial analysis.

  • >Monitor and manage the Accounts Receivable (A/R) aging report, identifying and addressing overdue accounts, and implementing collection strategies as necessary.

  • Collaborate effectively with the billing team and other departments to tackle special projects, such as process improvements, system enhancements, and revenue optimization initiatives.

  • Stay up-to-date with changes in billing regulations, coding guidelines, and insurance policies to ensure compliance and accuracy in billing processes.

  • Demonstrate adaptability in handling a variety of billing scenarios and proactively identify and address issues to maintain the integrity of the billing process.

  • Perform any other duties as assigned by management, contributing to the overall success and efficiency of the billing department.
    • Skills:
    Problem solving skills.

    Detail oriented.

    Ability to prioritize.

    Verbal and written communication skills.

    Ability to adapt to different situations.
    Qualifications:
    1. Education Requirements: Associate degree and/or Certified Medical Billing Specialist.

    2. Experience Requirements: At least one (01) year of medical billing experience. More than three (03) years of medical billing experience, preferred.

    3. Skills and Competencies Requirements Excellent verbal and written communication skills. Excellent problem-solving and critical thinking skills. Intermediate Microsoft Excel- preferred. High attention to detail. Ability to multi-task, prioritize and meet deadlines. Ability to perform repetitive tasks with a high degree of accuracy. Strong knowledge of various payer websites and interpreting denial reasons. Familiarity with HSys+, Ability ease All-Payer, CARETIME and HHAeXchange are preferred.
    Language Required: None
    Minimum Education: Associates Degree
    Minimum Experience: 1-2 years
    Contact Name: Human Resources
    Contact Email: resumes@cdrnys.org
    Contact Phone: (585) 546-7510
    The Center for Disability Rights strives to be a participant controlled, cross disability organization that is reflective of the community it serves. CDR values diversity and does not discriminate on the basis of age, color, cultural or ethnic group membership, disability status, educational level, family status, gender, income, national origin, race, religion, or sexual orientation. People with disabilities are encouraged to apply. CDR will make reasonable accommodations for qualified individuals with disabilities.
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