Billing Specialist - II

ORGANIZATION : Partners For Quality, Inc.
DEPARTMENT : Fiscal
POSITION : Billing Specialist - II
STATUS : Full Time; 37.5 hours/week
SCHEDULE / HOURS : Monday through Friday; 8:00AM - 4:00PM
LOCATION : Robinson Township

Partners For Quality Inc. (PFQ) is a private, non-profit organization based in Robinson Township. Partners For Quality provides administrative management to five subsidiary organizations that support local individuals with intellectual & developmental disabilities and behavioral health challenges. PFQ’s management services include Fiscal (including payroll), HR, IT and Communications thus allowing subsidiaries to focus on their day-to-day priorities.

Reports to the Revenue Cycle Director and/or Manager. Responsible for ensuring the accurate and timely processing of claims for Partners For Quality’s family of agencies’ Mental & Behavioral Health and Intellectual Disabilities/Autism services. Monitor and respond to unpaid claims, denials and appeals to minimize the days outstanding of accounts receivable. All responsibilities shall be completed in a manner consistent with Vision, Mission and Values of Partners For Quality, Inc.

Billing & Claims Processing

1. Prepare and submit invoices or claims to Medicaid, Medicare, private insurance, and other funding sources.
2. Verify client eligibility for services, when applicable.
3. Track and follow up on unpaid claims, denials, and appeals.
4. Work with the programs to navigate and mitigate failed claims, develop reports and share with program staff, track additional information as needed.
5. Position requires the ability to troubleshoot and figure out complex billing systems.

Financial & Administrative Support

1. Maintain accurate records of billing transactions, payments, and outstanding balances.
2. Assist with reconciliation of accounts and resolve billing discrepancies.
3. Work with finance and program staff to ensure proper documentation for services rendered.
4. Respond to inquiries from clients, insurance companies, and internal staff regarding billing issues.
5. Prepare and maintain additional reports as requested.
6. Perform other related duties as assigned.

Compliance & Documentation

1. Ensure compliance with federal, state, and agency specific billing regulations.
2. Keep up to date with changes in healthcare billing codes and payer policies.
3. Maintain confidentiality of client financial and personal information in accordance with Health Insurance Portable and Accountability Act (HIPAA).
4. Understanding and compliance with all Partner For Quality (PFQ) Financial Policies and Procedures and PFQ Corporate Personnel Policies and Procedures.

CASH INCENTIVES
Employees have the opportunity to earn additional money through our employee referral program

BENEFITS

• Full Time employees enjoy a comprehensive benefits package:
• Health, Dental and Vision Insurances
• $1,200 cash payout option in lieu of Health Insurance coverage
• Healthcare Flexible Spending Account
• Dependent Care Flexible Spending Account
• 16 to 26 Paid Days Off / year
• Wellness Days (2 per year)
• Sick Time
• 8 Paid Holidays
• Short Term Disability
• Long Term Disability
• Life Insurance
• Optional 401(k) with Employer match

WORK PERKS

• Paid orientation and training
• Free parking (select locations)
• Employee Activities, Rewards and Recognition Programs
• Comprehensive Employee Assistance Program

APPLY TO THIS POSITION

Interested applicants can choose to apply in any of the following ways:

Complete an employment application online

Email resumes:[email protected]

Partners For Quality and its family of agencies are an equal opportunity employer

EOE

1. Associate degree required or bachelor’s degree preferred
2. 3-5 years’ experience in a human services agency in medical or social services billing, Medicaid/Medicare claims processing, or financial administration.
3. Proficiency in Microsoft EXCEL & WORD applications
4. Proficient in all Microsoft EXCEL & WORD applications
5. Knowledge of medical billing software and/or electronic health records (EHR) systems.
6. Strong attention to detail and problem-solving skills
7. Ability to work independently and as part of a team in a fast-paced environment.
8. Valid Driver’s License and acceptable driving record
9. Act 33, 34 and FBI Clearances