Professional Medical Claims Coordinator
6 days ago
This role is a key part of the team at Martin De Porres Youth & Family Services, a reputable organization providing vital services to its community.
The estimated salary for this position is $53,000 - $65,000 per year, based on industry standards and location.
Job Description:
We are seeking a skilled Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will be responsible for ensuring all CFTSS and HCBS services are billed and adjudicated in accordance with New York State Department of Health (NYSDOH) and federal regulations.
You will coordinate with the Authorization & Payroll Specialist and Director of Behavioral Health Services to ensure seamless billing processes. Your attention to detail and ability to multitask will be essential in conducting follow-up correspondence to resolve open and denied claims via email or phone.
In addition, you will act as a liaison between MDPYFS and MMCPs (Medicaid Managed Care Plans) that insure the clients on the Behavioral Health Services Department's roster. You will maintain organized records and complete tasks quickly and efficiently, prioritizing tasks according to their urgency.
Requirements:
- Verify clients' eligibility weekly.
- Maintain updated billing profiles for all clients in the clearinghouse database.
- Report service provision overutilization including but not limited to fraud, waste, and abuse.
- Process, correct, and rebill claims for adjudication using ICD-10 codes if necessary.
- Audit Explanations of Payments (EOP) from MMCPs.
- Reconcile incoming payments.
- Resolve denied and underpaid claims via the dispute, appeal, or grievance process.
- Liaise between NYS Medicaid programs and MMCPs.
- Ensure ongoing communication with the Director of Behavioral Health Services regarding the escalation of service-impacting issues.
- Develop and implement process improvement initiatives.
- Perform ongoing independent research related to changes in industry standards.
- Attend quarterly Department meetings to provide necessary feedback.
- Perform all other duties as assigned.
Qualifications:
- Bachelor's Degree.
- At least two (2) years of administrative experience.
- Familiarity with billing and coding terminology.
Benefits:
- Competitive salary range: $25.00-$30.00/ hr
- Full Time-Exempt
- Required certifications may include Mandated Reporter, Trauma Informed Care, Lasallian Culture of Care, and Required training as delineated by the oversight agency and MDPYFS
- Ongoing support and professional development opportunities
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Medical Billing Coordinator
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Springfield Gardens, New York, United States Martin De Porres Youth & Family Services Full timeJob OverviewMartin De Porres Youth & Family Services is seeking an experienced Medical Billing Specialist to join our team. The successful candidate will be responsible for coordinating with the Authorization & Payroll Specialist and Director of Behavioral Health Services to ensure all CFTSS and HCBS services are billed and adjudicated in accordance with New...
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Professional Medical Billing Coordinator
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Springfield Gardens, New York, United States Martin De Porres Youth & Family Services Full timeJob OverviewMartin De Porres Youth & Family Services seeks a skilled Medical Billing Specialist to join our team.
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