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Billing Specialist Ii

4 months ago

Harrisburg, United States Palco Full time

**BILLING SPECIALIST II**

Palco is a visionary company pioneering an emerging health-care movement that empowers people with disabilities and those aging to live independent and quality lives. Made possible by our amazing team, Palco provides technology and financial services to aid individuals and their families to thrive in their home and communities. Partnered with government agencies and fortune 500 managed care organizations across the country, we are dedicated to creating exceptional outcomes for our clients and the millions of people that count on them. We are a highly organized company that offers flexible working hours, a solid work/life balance, autonomy, generous paid time off, bonus potential, and career advancement opportunities. Our staff make long-lasting impact on the lives of people every day.

The Billing Specialist supports the Billing Manager in all billing-related matters within the Financial Management Services (FMS) Department. Primary tasks will include billing and reconciling within mandated timelines for all programs supported. The Billing Specialist must demonstrate financial and analytical skills necessary to provide ongoing guidance and decision support to management and assist in executing FMS department processes, procedures, and goals.

**Duties and Responsibilities**:

- Understand and be able to execute all processes for billing programs.
- Working knowledge of submitting EDI claims, such as 837s.
- Conduct eligibility checks.
- Assist with provider enrollment with Medicaid, MMIS, and Managed Care Organization setups.
- Understand procedure billing and diagnosis codes, as well as denial reasons.
- Resubmit failed claims submissions.
- Prepare regular billing for all clients for management review.
- Compile, analyze, and evaluate billing data.
- Ensure company compliance with state and federal tax and regulatory authorities.
- Prepare or provide support for various ad-hoc projects initiated by management.
- Work with and support all clients, partners, and staff in FMS-related issues.
- Develop working relationships with partners and staff.
- Prepare and provide regular and ad-hoc reports to interested parties.
- Provide outstanding customer service to clients and business partners.
- Comply with HIPAA and other federal and state requirements.

**Education and Qualifications**:

- Experience with Medicaid, MCO and Veteran billing required
- Four (4) years of relevant experience in an office setting required.
- Experience with HP, DXC Medicaid Billing systems preferred.
- Must have good organization skills.
- Must have strong analytical and critical thinking skills.
- Must have a strong general understanding in tax, accounting, and finance areas.
- Must have strong interpersonal and communication skills, both written and verbal.
- Must demonstrate strong attention to detail.
- Must be able to work independently under tight deadlines. Must be willing to work Monday through Friday, 8:00am-5:00pm or additional time if necessary, to complete duties and responsibilities.

**Join Us**
- This position is remote/work-from-home role. Enjoy the convenience of working from home and maximize your time by unplugging at the end of your workday.
- Company benefits designed for you:

- Generous Paid time off.
- Quarterly/Annual bonus potential.
- Retirement Savings: We will support you as you save for your future.
- Career Growth Opportunities: We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
- Paid Training: Earn while you learn, and continue to grow with access to internal and external learning opportunities.
- Great Work Environment: We are proud of our company culture of collaboration and the recognition we’ve received for our diversity efforts.

When you join Palco, you are engaged in creating the future - both our company’s, the people we serve, and your own. We understand that our success is directly related to the success of our team. We strive to create a culture where you can:

- Bring your authentic self to work.
- Grow and thrive, both personally and professionally.
- Make a difference with our clients, in our communities, and with the millions of people we support.
- Experience work/life balance.
- Feel value and a greater purpose through the work you do.
- Palco, Inc. is an Equal Employment Opportunity (_**_EEO_**_) employer and does not discriminate in any employer/employee relations based on _race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law_.