Health Care Billing Specialist

2 days ago


Albany, New York, United States Research Foundation for Mental Hygiene Full time
Job Title: Health Care Billing Specialist

Join the Research Foundation for Mental Hygiene, Inc. as a Health Care Billing Specialist and play a critical role in ensuring the smooth operation of our mental health programs. As a member of our team, you will be responsible for submitting mental health program service claims to various insurance plans, reconciling payment of mental health program service claims to remittance statements, and assisting State staff with the maximization of cash flow from all payers.

Key Responsibilities:
  • Submit mental health program service claims to various insurance plans.
  • Reconcile payment of mental health program service claims to remittance statements.
  • Assist State staff with the maximization of cash flow from all payers.
  • Work with clearinghouses and insurance plans, and the billing system vendor, to resolve billing edits, denials, and correct any discrepancies about claim submission and remittance statements.
  • Educate and advise state staff on billing guidelines for various insurance plans.
Requirements:
  • Hold an associate degree from an accredited college AND two years of experience submitting health care claims to insurance plans in an automated environment.
  • A high school diploma or GED may be substituted for candidates who can demonstrate five years of related experience.
  • One year of working knowledge or experience with Microsoft Office (Word, Excel, Outlook, etc.)
Preferred Qualifications:
  • Understand reimbursement methodologies (e.g., Diagnostic Related Groups (DRG), Ambulatory Payment Classification (APC), and Ambulatory Patient Groups (APG)).
  • Medical coding certification
  • Experience with Oracle Cerner's Soarian Financials billing application
  • Understand government insurance plans (i.e., Medicaid and Medicare), and commercial insurances and managed care, including both claims submission and remittance statement processes.
  • Understand medical coding terminology (e.g., HCPCS, CPT and modifiers).
Working Location:

44 Holland Avenue, Albany, NY

To Apply:

Submit an application through our website at https://www.rfmh.org/careers

Please note only applications submitted through our website will be considered.

The Research Foundation for Mental Hygiene, Inc. is an equal opportunity/affirmative action employer.

Employees of the Research Foundation are not state employees, do not participate in any state retirement system, and do not receive state fringe benefits.

Excellent Benefits Package. Employer/Minority/Women/Disabled/Veteran Employer. VEVRAA 41 CFR a) compliant.



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