Medical Billing Specialist

3 weeks ago

Manchester, United States 21 Plus, Inc. Full time
21 Plus is looking for a Medical Billing Specialist, who is responsible for processing Medicaid billing, claims, and service documentation . The position will be located in Manchester, NJ.

*Medical Billing Specialist Duties:*

* Oversees and monitors all aspects of Medicaid eligibility and billing.
* Confirms consumer Medicaid eligibility in NJMMIS Portal.
* Reviews and obtains SDRs and Prior Authorizations service documentation all consumers.
* Updates Rates and Client Tier information in the Netsmart System as needed.
* Prepares/submits Medicaid claims electronically using Netsmart system and the HIPPA NJMMIS portal.
* Prints Medicaid billing report, save to drive and prepare excel Templates for recording of Medicaid billing into Sage Accounting Software.
* Follows-up on all claims from billing through final resolution, maintain accurate and current Accounts Receivable.
* Downloads Remittance advices and 999s for entry into Netsmart and recording of the payrment in Sage Accounting Software.
* Posts payments in Netsmart via 999 upload
* Reviews and follows up on remittance advice for payment errors, denials and under/over payments.
* Interprets EOB and collections reports accurately.
* Generates reports regarding revenue, pending claims, dates of payment, etc.
* Facilitates billing operations by following policies and procedures; HIPAA compliance and reporting compliance issues.
* Prepares, sends and records all financial transactions related to billing and receipt of payments for all clients rent and contribution to care fees.
* Prepares and coordinates all financial transaction related to the Supportive Housing Corporation (SHC) rental assistance program grant.
* Coordinates and assembles documentation, with assistance from Residential Services, of the consumers Social Security and Medicaid renewal submissions to Social Security and Medicaid.
* Prepares and submits monthly Medicaid Attendance Projection, Medicaid Actual vs. Projection, Placement & Vacancy and Residential Billing Attendance reports to the Finance Director.
* Prepares, reviews and submits client Trust applications. Maintain all Trust files including but not limited to deposits, withdrawals, receipts and monthly Trust statements. Work collaboratively with Trust Administrator, Guardians, SPA’s and Directors to assure all documents are received and processed in a timely manner.
* Reviews all monthly client PNA reports received from SPA’s for accuracy, receipts and proper documents to ensure client funds are being tracked and accounted for. Notify the Finance Director and Director of Residential Services of any issues that are discovered, questions or corrections that may be required.
* Prepares and submits the annual Social Security Rep Payee for all consumers to the Finance Director for review and approval.
* Assists, when time allows, in preparing the monthly Rep Payee Bank Reconciliations.
* Works collaboratively with the finance team members and assist with other projects as necessary.
* Cooperates with the licensee and the Department of Human Services staff in all investigations and inspections.
* Adheres to the organization’s financial policies and procedures.

*Qualifications:*

* 3-5 years medical billing experience required (experience billing with an Electronic Health Record System required)
* Medical billing experience and familiarity with SSI /SSA renewal packages preferred.
* Intermediate to advanced knowledge of MS Office and Excel.
* Associates Degree preferred.
* Full knowledge of accounts receivable, accounting excel spreadsheets and general accounting practices.
* Must be at least 18 years old, have a valid NJ Driver’s License with an acceptable record of safe driving
* High School Diploma / GED (verifiable)

*PLUS*

* Excellent time management skills.
* Strong organizational skills.
* Clear verbal and written communication skills.
* Ability to multi-task and meet deadlines.
* Sound judgment and decision making skills.

Job Type: Full-time

Benefits:
* Dental insurance
* Employee assistance program
* Health insurance
* Life insurance
* Paid time off
* Vision insurance
Schedule:
* Monday to Friday

Education:
* High school or equivalent (Required)

Experience:
* Medical billing: 3 years (Required)

Ability to Commute:
* Manchester, NJ 08759 (Required)

Work Location: In person

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