Job Description

Job Description

Job Description

ABOUT THE ORGANIZATION:

Established in 1970, Boley Centers, Inc., is a private, non-profit organization serving individuals with mental disabilities, individuals and families who are homeless, Veterans and youth in Pinellas County.

BENEFITS:

10 paid holidays per year

Paid Time Off

Medical/Dental/Vision/Life Insurance

Tuition reimbursement

Continuing education, reimbursement for professional certifications, licensure and qualified supervision

JOB DESCRIPTION:

Responsible for all functions of third party billings; including, but not necessarily limited to, processing new applications, processing private and government insurance billing, reviewing delinquent accounts, resolving claim denials, submitting claim appeals, posting payments and adjustments, managing collections and reporting claim status’s to program team leads and supervisor.

PRIMARY JOB FUNCTIONS:

• Responsible for the billing process for Medicaid, Medicare, and private insurance.
• Ability to develop procedures, schedule, and complete audit of programs for accurateness of reporting charges for services rendered and monies collected.
• Reviews delinquent accounts to identify write-offs; submits write-offs.
• Ability to work with IT and Finance departments to coordinate service tracking to Accounts Receivable for all funding sources.
• Ability to review accounts receivable system and recommend changes when necessary.
• Ability to review and resolve client account balances.
• Prepares and transmits electronic Medicaid/Medicare billing.
• Prepares and submits check requests for insurance adjustments.
• Develops appropriate policies, procedures and forms related to billing functions, as necessary.

• Coordinates with medical records to ensure documentation follows Medicaid and/or other internal or external requirements.
• Accomplishes appropriate coordination, activities, as necessary with other departments, organizations, agencies, etc. regarding routine or special billing matters.
• Coordinates with medical records to ensure documentation follows Medicaid and/or other internal or external requirements.
• Reviews daily units of service for accuracy.
• Prepares and submits billing reports to accounting department.
• Completes other duties as assigned.

EDUCATION AND EXPERIENCE:

• High school diploma or GED equivalent required.
• Certified Professional Biller Certification required.
• A bachelor’s degree from an accredited college or university in accounting is preferred.

Requires a minimum of five years’ experience in the healthcare revenue billing cycle for both facility (part A) and professional services (part B) to include: submitting claims compliant with government regulations and/or private payer policies; following up on claim statuses; resolving claim denials; submitting claim appeals; posting payments and adjustments; and managing collections.

• Knowledge of billing practices to include claims submission, follow up, and denial resolution
• Knowledge of governmental and/or private payer regulations and guidelines for billing
• Knowledge of posting payments/adjustments and managing collections
• Knowledge of supervising maintenance of the accounts receivable system

SKILLS AND ABILITIES:

• Knowledge of billing practices to include claims submission, follow up, and denial resolution
• Knowledge of governmental and/or private payer regulations and guidelines for billing
• Knowledge of posting payments/adjustments and managing collections
• Knowledge of supervising maintenance of the accounts receivable system
• Ability to use a variety of computer software proficiently
• Ability to prioritize workload
• Ability to communicate effectively with co-workers and outside agencies
• Ability to sit at a desk and view a monitor for extended periods of time
• Good vision and hearing

SPECIAL REQUIREMENTS:

Must pass a level II background check and drug screen.

Must have valid driver's license.

Reasonable accommodations will be made for otherwise qualified individuals with a disability. Veterans encouraged to apply. Boley Centers is a drug-free workplace that adheres to federal regulations as it pertains to marijuana use.

EOE/ADA/VETERANS/DFWP

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