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Key/Essential Functions & Responsibilities
Maintains responsibility for all day-to-day processing, maintenance and tracking of billable services/ receivables for assigned region/area(s), regularly collaborating with applicable program management and/or other finance staff to support complete and accurate billing of services with state and/or federal agencies.
Receives and responds to billing inquiries from program management, coordinating resolutions to billing-related matters in area of assignment, providing education and/or troubleshooting billing system and electronic medical record issues or redirecting inquiries to appropriate parties for assistance; escalates concerns to supervisor for assistance and handling, when needed.
Collaborates with other members of finance team for billing-related matters, which may include identifying and assisting with resolutions to eligibility issues and coordinating with external parties if/as needed, checking eligibility in applicable electronic systems, preparing and distributing reports or statements and collecting information.
Runs, reviews and shares monthly billing reports from electronic billing system to ensure that all services are reviewed and approved for billing by program management within established timelines to support compliance with all applicable deadlines.
Conducts regular follow-ups with program management to secure confirmations and ensure timely and complete processing of billing and to maximize reimbursement for services.
Makes updates to billing-related information in electronic systems on a timely basis to support automated billing processes and/or transmits or resubmits corrected claims electronically in accordance with applicable agency requirements.
Reconciles billing reports and entries within applicable electronic systems by flagging individuals and/or specific services without posted payments on a monthly basis and collaborates with program management to determine corrections needed, following up on a regular basis until payment has posted.
Tracks receipt of payments in applicable systems, retrieving documents and files and posting all payments into the electronic billing system.
Provides regular updates to other finance department staff and escalates billing, state or other agency concerns or issues and inefficiencies to supervisor for handling.
Performs a variety of clerical, administrative and financial tasks to support revenue management department as requested including, but not limited to filing, copying, scanning and/or data entry; creating memos, lists, spreadsheets or other documents; receiving and sorting mail and/or making notifications or inquires by email or phone.
Assists Director of Revenue Management with gathering data and documents for requests by Quality and Compliance department and/or for any other program or financial audit or review.
Assists with maintaining the Accounts Receivable (A/R) aging for programs, where applicable, which includes working with programs to reconcile any outstanding accounts receivable and providing invoices upon request, coordinating with entitlements team and program management to collect information needed to obtain authorizations for services to support billing or to recalculate and reallocate funds for retroactive payments.
May manage client fees for residential services using applicable electronic systems to generate reports and/or conduct manual review of payments received for individuals including receiving checks and processing/posting payments, documenting appropriately in electronic billing system and/or for General Ledger.
May coordinate review and allocation of funds or allowances, creating accurate files and identifying appropriate allocations in collaboration with supervisor and confirm distribution of related funds.
Complies with all Federal, State, Local and other relevant regulatory agency requirements, including the Health Insurance Portability and Accountability Act (HIPAA) and ensures cooperation with appropriate entities in any inspection, inquiry or investigation.
Performs all other duties, as assigned.
Minimum Qualification Requirements including education, experience, licensure/certification, etc. and essential physical capabilities (e.g. lifting, assisting lifting, standing, etc.)
High School diploma or its educational equivalent; and
Two (2) years of experience working with the I/DD population or related experience in human or social services including assisting people in applying for services and/or exposure to benefits or entitlements; or
Two (2) years of experience performing administrative support duties relating to finance or healthcare-related billing including data entry, tracking data, accounts receivable, bookkeeping or similar duties; or
Satisfactory equivalent combination of education, experience and/or training.
Ability to report on-site to our Manhattan office at least three (3) days per week in accordance with the Agency’s Return to Office Policy.
Familiarity with benefits and entitlements in the healthcare and/or I/DD field including Medicaid, Medicare and applicable regulatory agencies.
Strong written and oral communication skills, including the ability to effectively obtain and communicate information with staff at varying levels.
Detail oriented and highly organized with good time management and follow-up skills, including the ability to effectively track and accurately compile data.
Basic quantitative and problem-solving skills, including the ability to identify discrepancies and escalate accordingly.
Ability to prioritize multiple tasks to meet billing submission deadlines.
Ability to work autonomously and work well in groups, including building relationships and working collaboratively with program management and other finance staff.
Proficiency with computers and ability to quickly learn electronic systems including Digital Agency (DA), electronic health record, Workday and state-specific systems or portals and working knowledge of Microsoft Office applications, specifically Excel and Word.
Ability to meet essential physical demands of position including: using hands to finger, handle or feel objects, tools or controls; sitting, standing, bending, twisting and reaching with hands and arms.
Preferred Qualification Requirements (desired requirements beyond MQRs above)
Previous experience with medical billing and systems, specifically billing for services received by individuals with I/DD in assigned state of operations (NY, NJ or CA)
Compensation
$45 per hour
This is a temporary position for up to three months, with the potential for extension depending on the needs of the business.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or status as a Vietnam or disabled veteran. YAI is an Equal Opportunity Employer.
To ensure fairness, safeguard transparency, and promote an equitable workforce environment, YAI Network prohibits the practice of nepotism in the workforce and hiring process.