Medical Billing & Scheduling Specialist
Scranton, PA
Leonard Workforce Solutions is recruiting a Medical Billing & Scheduling Specialist for my client, Jewish Family Service of Northeastern Pennsylvania in Scranton, PA.
This is a full-time, ON-SITE position, with the work schedule being Monday - Friday, typically 9:00am - 5:00pm.
*** Part-time schedule is an option ***
The Medical Billing and Scheduling Specialist will work closely with the Executive Director, Social Workers and key administrative staff to process all insurance, contracted and client financial responsibility claims for services rendered. This includes the precertification of potential clients, verification of eligibility, creating accounts for all clients in electronic billing system, tracking units of service as well as required collection of demographic data and necessary reporting. Medical Billing and Scheduling Specialist will take on an Administrative role as a super user in the Credible software.
Responsibilities:
1. Review all new clients entered by the Social Workers as “Pending” into the Credible Software. Complete precertification of potential clients prior to intake including verifying insurance eligibility and benefits to determine client financial responsibility and fee agreement. Report to the Social Worker who entered the “Pending” client of your findings regarding insurance eligibility. Once it is determined which Social Worker will be taking on the new client, set up the Client’s account making it an Active account.
2. Review data on Encounter Forms for all scheduled appointments for each social worker to include all pertinent session information for billing purposes as well as any client payments made at time of service. Information submitted by the Social Worker on the Encounter forms will be used to match the claim created by the Social Worker upon completion of their session note for the billing of a clean claim to the insurance company or to complete the processing of a claim in situations where client has other form of payment beside insurance according to their fee agreement.
3. Create and submit electronic claims via Credible to the Credible Express Clearinghouse Change Healthcare. Save all Change Healthcare claim batch files on the Share Drive. Correct and resubmit any claims rejected by Change Healthcare. Create, print and mail any paper claims to the insurance companies only as needed.
4. Print and post from all insurance payer sites insurance payments received for claim submitted. Post all client payments received. Print out an end of day report from electronic billing software for daily balancing of payments received.
5. Reconcile all payments received on a monthly basis with the Business Manager.
6. Create, print, and mail all client statements at the beginning of each month. Review any non-paid client statements and forward to the client’s Social Worker after the 3rd statement mailing with no payment received for their review and advice on further proceeding with the “collection” process.*
7. Review accounts receivable reports by insurances and keep the receivables current to ensure timely filing of claims. Investigate any incorrectly paid or unpaid claims.
8. Create Credible tasks through the online Credible Task System in order to have any Credible-based questions or issues resolved.
9. Ensure ongoing compliance of new and revised billing procedures and requirements.
10. Be aware of and perform updates as required by the software vendor.
11. Track established markers for the following programs in a defined excel spreadsheet on a monthly basis with final month end reporting to the United Way and/or other funding sources as well as the Board Members, all Counselors, the Executive Director and Business Manager: Counseling, Care & Case Management, KMOW and Guardianship.
12. Track Adult Service Grant (ASG) sessions and report sessions to the Business Manager who in turn will report to Lackawanna County on a monthly basis.
13. Complete provider enrollment forms to become participating providers with desired insurance companies and maintain or expand credentialing.
14. Assist the Business Manager by tracking measurable outcomes for services provided as well as client base demographic information.
15. Operation of standard office equipment and agency telephone system.
16. Other duties as deemed necessary by the Executive Director.
Qualifications:
High school diploma or equivalent with experience or certification in medical or related business or healthcare industries.
Proficiency in billing software and experience with ICD-10 and CPT codes necessary.
Strong communication and interpersonal skills.
Attention to detail, accuracy and organizational skills.
Computer skills in Microsoft Word and Excel required.
Why This Job, Why This Company:
Starting pay rate of $15 - $22/hr. (DOQ)
Employee covered medical, dental, vision, and prescription drug plan
403 (b) Tax Deferred Annuity Plan for employee voluntary contributions
401 (a) Employee Pension Plan for employer contributions, no match required
Long Term Disability, Life Insurance
Generous PTO to include up to 4 weeks vacation, holiday, and sick time
Employee Sam’s Club membership
Interested parties should email their resume and a note of interest to LeonardWorkforceSolutions@gmail.com
STATUS: Recruiting