A longstanding not-for-profit outpatient community behavioral health clinic in Queens, NY seeks a personable, detail-oriented and organized Posting and Claims Specialist with 2 + years of posting and claims processing experience in a behavioral health clinic or medical office to join our team. Experience with OMH Article 31 and OASAS Article 32 strongly preferred.
This is an on-site only position.
Our Posting and Claims Specialist will perform the following functions:
- Post EOBs electronically via ERA or manually
- Process incoming payments in compliance with financial policies and procedures
- Match ERA (Electronic Remittance Advice) transactions with corresponding claims to ensure accurate patient account payments. Reconcile daily deposits to ensure that all payments are accounted for and properly posted
- Monitor and track submitted claims to ensure they are processed and paid promptly
- Troubleshoot and resolve billing issues, rejections, denials, and appeals
- Review and correct claims to ensure proper reimbursement and compliance with payer regulations; Handle collections on unpaid accounts
- Monitor patient account details for non-payments, delayed payments, and other irregularities
- Review and analyze EOBs payer correspondence to identify denials; Communicate denials trends/issues to management
- Maintain up-to-date knowledge of billing regulations and insurance guidelines specific to behavioral health
- Handle sensitive and confidential information appropriately and in compliance with HIPAA regulations
- Work directly with insurance companies, healthcare providers, and patients to get a claim processed and paid in a timely manner.
- Verify and update patient insurance information as necessary
- Communicate with patients regarding their billing questions, payment options, and account status
Skills and Qualifications:
- High school diploma or equivalent and 2+ years of insurance experience (commercial, Medicare and Medicaid).
- Prior experience with Managed Care, NY State-OMH, NY State-OASAS and third-party processes and billing practices preferred.
· Strong attention to detail and accuracy.
· Knowledge of the ERA denial codes, and remark codes required.
- Proficiency with electronic health records (EHR) systems and medical billing software a must. Experience with CareLogic billing software is a tremendous PLUS.
- Certification in medical billing and/or coding preferred.
- Excellent computer skills, including MS Office and database management.
- Knowledge of Federal and NY State patient privacy regulations/laws.
- Excellent organizational skills, including the ability to set priorities and manage multiple projects simultaneously, track work details, and respond flexibly to change.
- Ability to remain calm, focused and helpful under stress.
- Excellent communication, follow-up and interpersonal skills.
Benefits:
We offer a competitive compensation package, which includes health and dental insurance, as well as, generous paid leave.
Diversity:
We are an equal opportunity employer, and actively cultivate a diverse workplace. All employment decisions are made without regard to actual or perceived age, race, sex, religion, creed, color, citizenship, sexual orientation, ethnicity, familial status, liability for military service, genetic pre-disposition or carrier status, national origin or ancestry, disability, veteran status, marital status, gender identity or expression, status as a victim of domestic violence, or any other bases protected under federal, state and local laws, regulations or ordinances.
Job Type: Full-time
Pay: $55,000.00 - $60,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Ability to Relocate:
- Elmhurst, NY 11373: Relocate before starting work (Required)
Work Location: In person