Billing and Accounts Receivable Specialist

Woods Services; Langhorne (Bucks County); On-site; USD 24,000 - 34,000; Full time

Benefits offered by this job

Medical/Dental/Vision

Life & Disability Insurance

Paid time off

On-site medical center

403b retirement plan

Continuing education

Tuition assistance

Career growth

Job summary

Woods Services in Langhorne, PA seeks a Billing and Accounts Receivable Specialist to handle accurate and timely billing to Medicare, Medicaid, managed care and other payers. Duties include posting payments, verifying authorizations, and AR follow-up to maximize reimbursement.

The role requires practical knowledge of Medicare/Medicaid billing, strong organization, and excellent communication skills. On-site role with mission-driven team and opportunities for growth.

Qualifications

• High School Diploma required.
• Minimum of three years’ work experience in Medicare/PA Medicaid, Managed Care and Third Party funders.
• Experience with computerized healthcare billing software; healthcare billing experience preferred.

Responsibilities

• Ensure timely, accurate processing and submission of 837/CMS-1500/UB-92 invoices to payers.
• Verify insurance eligibility and use ICD/CPT/HCPCS codes correctly for accurate payments.
• Enter and maintain authorizations in the EHR; report authorizations/eligibility to clinical team.
• Post payments in the billing system within five business days of receipt.
• Identify and resolve unpaid claims; monitor AR aging and collections.
• Provide exemplary customer service to external stakeholders and internal teams.

Skills

Interpersonal skills

Communication skills

Attention to detail

Education

High School Diploma

Tools

Medical billing software

Job description

Overview

We want you to join our team! We need deeply compassionate, committed and highly talented staff. The Woods organization is guided by their mission to support children and adults with disabilities or challenges to achieve their highest potential and independence through innovative and individualized approaches that promote learning and personal fulfillment.

Benefits

• Medical, Dental, Vision Insurance
• Life and Disability Insurance
• PTO -Paid time off
• On-site FREE medical center
• 403b retirementplan
• Continuing education programs
• Tuition-assisted program
• Career growth opportunities

Salary: Starting at $21 / hour – depending on experience / education

Job Summary

As a member of the Revenue Cycle Team, the Billing and Accounts Receivable Specialist is responsible for the accurate and timely billing of services, to Medicare, Managed Care, Medicaid and Motor Vehicle claims. Posting of payments, verification of authorizations, claims resolution and accounts receivable follow-up of outstanding balances.

Responsibilities

Billing Duties

• Ensures timely, accurate and efficient processing and submission of all 837 electronic invoices and CMS-1500 and UB-92 claims/invoices to payers.
• Performs insurance eligibility verifications; correctly utilize ICD diagnosis codes, CPT/HCPC codes and modifiers to ensure accurate and timely payments.
• Utilizes knowledge of the pre-certification and authorization process to ensure all certifications and authorizations are valid and accurate.
• Enter and maintain authorizations in the Electronic Health Record.
• Reporting of authorizations and eligibility to the clinical team.
• Ensures compliance with billing practices, policies and procedures by leveraging strong knowledge of the policies and rules stipulated by Medical Assistance, Managed Care, Third Party and Auto Liability payers.
• Verifies client eligibility and funding changes.
• Tracks and report changes that may impact reimbursement.
• Submits timely claim corrections and resubmission of invoices and claims when necessary.
• Maintains client billing records.

Cash Duties

• Accurately posts of payments in the billing system to appropriate client accounts within five business days of receipt.

Accounts Receivable Duties

• Identifies and resolve unpaid claims and report issues to supervisor.
• Monitors weekly and monthly reporting on the status of accounts receivable over 30 days in arrears, provide details of collection efforts and issues with securing reimbursement.
• Performs collection actions including contacting funders, clients and guarantors by phone, email, and mail.

Other Duties

• Provides exemplary customer service to external stakeholders and internal clients.
• Works collaboratively with other departments and programs to gather and provide information on authorization and eligibility issues.
• Maintains quality results by following established policies and procedures.
• Shares knowledge of current regulations, policies and developments with team members and other stakeholders.
• Maintains strict confidentiality with regard to all client information. Adheres to all HIPAA guidelines/regulations.
• Demonstrates a strong commitment to performance accountability.
• Responds to inquiries from funders and Woods management staff regarding billing and account related matters.
• Attends relevant seminars and training sessions to improve knowledge, skills and performance as specified by the Billing Supervisor or the Revenue Cycle Manager.
• Other duties assigned by the Billing Supervisor or the Revenue Cycle Director.

Qualifications

Education: High School Diploma Required.

Experience: Minimum of three years’ work experience relevant to the duties and responsibilities of the position required. A high level of experience with Medicare, PA Medicaid, Managed Care and Third Party funders, including coordination of benefits. Previous experience with computerized billing software and healthcare billing strongly desired. Experience with billing in a healthcare environment required.

Other: Strong interpersonal skills and a solid work ethic. Excellent organization and communication skills, clerical and numerical proficiency and familiarity with Windows-based software application packages. Demonstrate the ability to handle multiple tasks, adhere to established deadlines, and produce work that consistently meets or exceeds team benchmarks.

About Woods Services

Woods Services is a Pennsylvania and New Jersey-based non-profit population health network and advocacy organization that along with its six affiliate organizations provides life-long innovative, comprehensive and integrated health, education, housing, workforce, behavioral health and case management services to more than 22,000 children and adults in the intellectual and developmental disability, child welfare, behavioral and brain trauma public health sectors who have complex and intensive medical and behavioral healthcare needs.

Our Langhorne campus is home to 550 residents and provides outpatient and day programs.