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Senior Medical Biller - Nathaniel Clinic

Center for Alternative Sentencing and Employment Services (CASES)

Description

Job Title: Senior Medical Biller – Nathaniel Clinic

Reports to: Director

Overview: CASES Nathaniel Clinic a new Article 31 outpatient mental health clinic scheduled to open in October 2014 located in Central Harlem. The clinic which will serve justice-involved youth aged 13 and above and adults, is seeking a seasoned Senior Medical Biller to lead all medical billing activities. This position is responsible for the oversight and reporting of all billing functions for the Clinic including Medicaid as well as Managed Care, Medicare, and Third Party insurance. This position requires someone with knowledge and proven experience in Article 31 billing and coding using an electronic medical record (EMR) and electronic claims. The supervisor performs work with good humor and flexibility and has frequent contact with clinic clients, other CASES departments, and the mental health ACT programs that are co-located in the same space. In addition, the Senior Medical biller will supervise two Front Desk Schedulers and will be responsible for leading all the administrative activities for the clinic, ensuring our clients are warmly greeted and quickly scheduled into services, and that the clinic meets its productivity goals.

Responsibilities:

• Generate daily claims and invoices using EMR system
• Check status of all claims billed to ensure the billing process is completed on schedule and problems are identified and resolved
• Complete billing from the Clinic’s main location including the coordination of billing for the satellite location
• Monitor all billing to ensure timely response to any rejected or denied claims and resubmit these claims after issues have been resolved
• Post payments and denials received from insurance carriers and make corrections to claims as necessary and contact insurance carriers to get information on denials
• Work directly with multiple providers, Medicaid, Managed Care Plans, Medicare, and health insurance carriers to achieve maximum collection results
• Conduct telephone and website inquiries regarding claim status
• Oversee the work and performance of the clinic’s scheduling staff to ensure they perform their receptionist, administrative and clerical functions in accordance with CASES policies and procedures and the delivery of effective and respectful services for clients
• Coordinate the clinic’s centralized appointment scheduling through the electronic medical record (EMR) ensuring clinical staff work schedules are entered at least 60 days in advance, cancelled appointments are backfilled, No Shows are reduced, and clinical staff attain productivity goals
• Supervise the work of the two schedulers/customer service representatives to ensure clients and agencies seeking access to clinic services receive excellent services
• Supervise schedulers/customer service representatives performance of administrative and clerical support to all clinical staff including, photocopying, faxing correspondence, creating letters to external sources via the EHR, updating consent forms, mailing letters, sending mailings, coordinating transmission of progress reports to criminal justice agencies including CASES ATD/ATI program staff
• Provide administrative support to the clinic director including scheduling meetings and trainings, ensuring all necessary meeting materials are available
• Establish and maintain effective working relationships with central Fiscal staff and executive staff
• Respond timely to requests for information from CASES staff
• Work with Clinic Director to analyze payment trends and implement corrective action to maximize receivables
• Support Clinic Director in preparation for program certification and fiscal audits
• Order office supplies for clinic
• Oversee the collection and management of co-pays
• Maintain petty cash account in accordance with CASES’ policies and procedures for distribution and reconciliation of funds
• Oversee Metrocard ordering and reimbursement
• Provide front desk lunchtime scheduling coverage
• Coordinate time sheet collection & pay check distribution
• Provide culturally competent services in accordance with CASES policies and procedures
• Any other duties as required by the director and executive staff

Qualifications

• Associate Degree in a related field
• Medical Coding and Billing Certificate
• Four years of medical billing experience with 2 years Article 31 billing
• Extensive knowledge of Medical Terminology, CPT-4 and ICD-9/ICD-10 Coding and knowledge of federal, state, and third party rules and regulations
• Excellent customer service, communication and written skills
• Ability organize systems and to operate with purpose, urgency, and accuracy in a fast-paced deadline-driven environment
• Demonstrated proficiency in MS Office Suite and EMR
• Fluency in Spanish preferred

Contact

How to apply: E-mail cover letter and resume in Word to [email protected]. Please list the Senior Medical Biller in the subject line. No phone calls please. Only applicants selected for interviews will be contacted.

Posted on 10/14/14; CVMHA ID #8261