Billing Specialist Apply Now Email Job SNAPSHOT: Company:JEVS Human Services Location:1845 Walnut St 1845 Walnut St Philadelphia, PA 19103 Employee Type:Full-Time Industry:Not for Profit - Charitable Job Type:Accounting, Admin - Clerical Education:4 Year Degree Experience:At least 2 year(s) Manages Others:No Post Date:1/15/15 Ref ID:Billing Specialist DESCRIPTION: I. Summary of Major Duties/ Responsibilities: The FMS Billing Specialist is the senior operations position for advanced, automated and manual billing, eligibility service , provider service enrollment/coverage procedures, electronic posting of cash & remittance advice, Accounts Receivable collections, Accounts Payable(where required), Revenue Accounting & Reporting (G/L), communications with funders, audit preparation and internal and regulatory compliance. Coordinate and maintain the billing of consumer service worker actual activity (units). Coordinate and analyze approved consumer units with actual units used and communicate usage overages to Payroll Department. Communicate all eligibility issues to appropriate departments and funders. Coordinate, review, process and document billing, billing adjustments, re-submissions, write-offs, retroactive rate changes and late service charges. Report error rate and review/maintain correction procedures. Maintain funder procedures manuals and follow-up on claims billing requirements published from various agencies, DPW software support and other government funders. Coordinate, prepare and analyze required end of month reports. Act as Liaison between Billing Department and Corporate Finance Office. Analyze, prepare and submit monthly closing schedules and accrual reports to Corporate Finance Office by predetermined deadlines. Coordinate and maintain timely turnaround of claims, claims adjustments, rejections, collections and claims resubmissions to maximize cash flow and revenue. Assist in the initiation, tracking and resolution of appeals submitted to funders. Coordinate and prepare reconciliations of billings, cash and remittance postings with Accounts Receivable balances. Produce and distribute all required reports and other required data/documents to funders. Establish acceptable staff productivity levels, routinely assess staff productivity and coordinate staff trainings as needed. Coordinate and implement additional billing-related processes for program expansion with other funders. Participate in the planning, testing, implementation and maintenance of new billing software systems and other related software packages. Maintain the internal/ external claims audit functions and procedure as assigned. Evaluate, maintain & improve methods of Billing and Accounts Receivable processes. · Comply with all management directives regarding billing guidelines, regulations, new requirements and systems. Participate in Quality Improvement Process. Evaluate, improve and maintain established policy & procedure necessary to ‘trouble shoot’, record, report issues and recommend resolution options to all stakeholders to reduce errors, omission and lost revenue or consumer service. Communicate with management & staff at all levels. Maintain confidential or sensitive information under HIPPA regulations. Accountable for research and disclosure of claim accuracy and legitimacy under FMS Provider compliance rules, fraud & abuse regulations Prepare & review monthly actual to budget revenue analysis, AR turnover & collections. Access contracted agency and government websites to review and summarize changes in rules, regulations, guidelines and directives that impact claims processing. Prepare and maintain statistics for benchmark performance and Total Quality Control as assigned. Other duties as assigned. II. Skills: Must have an advanced level of computer skills and working knowledge of PA DPW PROMISe, HCSIS or other State medical systems for billing, cash posting & accounts receivable, general ledger and financial analysis applications such as SMS, Mysis, First Data, Great Plains, Webcare, MAS-90 or other major software system. Must have an advanced level of PC skills navigating and using MS products such as MS Word, Excel, Outlook, SQL or other analytical software. Must be able to work independently with minimal supervision in a fast paced team environment. Must have excellent verbal, written communication skills. Must demonstrate excellent skills in multi-tasking, organizing task/ priority, problem-solving and follow-up. Must have advanced customer relations skills in working with internal and external staff, funders, clients, vendors and county officials. Must be able to analyze and report statistical relationships using advanced math & accounting skills. REQUIREMENTS: III. Education/ Experience: Bachelor’s degree preferred in accounting or related field with at least two (2) or more years of experience in coordination of automated and manual, medical/ insurance claims processing, billing, cash & remittance posting, collections, accounts receivable analysis, financial reporting in the governmental, health care or public accounting field. In lieu of a Bachelor’s degree, an Associate’s degree in business management with accounting, business math, statistics, computer science and at least four (4) years of advanced experience in automated and manual, medical/ insurance claims processing, billing, cash posting, collections, & accounts receivable, financial reporting in the insurance/ governmental, public accounting or health care claims processing industry. Candidates’ for this position must achieve required scores in entrance level testing for Intermediate Excel, Accounts Receivable and Call Center Customer Service skills and other related abilities as required. The FMS Billing Specialist must achieve required scores in skills testing in order to advance in the job category.
Posted on: Wed, 28 Jan 2015 00:26:43 +0000
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