Billing Specialist

Community Options Job Board; Princeton (NJ); On-site; USD 52,000 - 65,000; Full time

Benefits offered by this job

Competitive insurance benefits

Paid holidays

Generous PTO

403b retirement plan

Career growth opportunities

Job summary

Community Options, Inc. in Princeton, NJ is seeking a Billing Specialist to manage Medicaid reimbursements, ensure compliance with laws, and maintain accurate accounts receivable records.

You will collaborate with branches and payers to resolve discrepancies and support internal staff. This on-site, full-time role requires at least two years AR/billing experience, a high school diploma, and proficiency with NetSuite, Word and Excel.

Qualifications

• High School Diploma or equivalent.
• Minimum of two years accounts receivable/billing experience.
• Proficiency in NetSuite, Microsoft Word and Excel.
• Excellent verbal, written, interpersonal, and communication skills.
• Knowledge of general accounting principles.
• Valid driver's license with satisfactory driving record.

Responsibilities

• Process initial claims from Therap or other applicable billing platforms by examining, calculating, and/or adjusting claims.
• Maintain billing platform to ensure accuracy of financials and submitted billing.
• Submit claims to payers manually or electronically.
• Resolve a high volume of disputed claims by gathering, verifying, and providing additional information, following up on claims.
• Monitor collections of receivables.
• Monitor and resolve AR report receivables over 90 days old.
• Monitor, process, and resolve appeals of receivables.
• Monitor filing deadlines for each designated payer and ensure processing is completed in that timeframe.
• Correct claims when errors occur (e.g., ICD-10, Authorization number).
• Collaborate with branch offices, claims processors, and billing department to ensure collection and resolve disputes throughout the lives of claims.

Skills

Communication skills

Education

High School Diploma or equivalent

Tools

NetSuite

Microsoft Word

Excel

Job description

Community Options, Inc. is a national non-profit agency providing services to individuals with disabilities in 12 states.

We are seeking aBilling Specialist in Princeton, NJ to be responsible for ensuring Community Options, Inc., is following all aspects and levels of federal, state, and local laws, regulations, and standards within the realm of billing and accounts receivable. The Billing Specialist is responsible for ensuring Community Options, Inc is in compliance with all aspects and levels of federal, state, and local laws, regulations, and standards within the realm of billing and accounts receivable. This person will collect Medicaid reimbursements by resolving discrepancies, adjusting claims, preparing reports, monitoring collections, and providing excellent customer service to internal staff and designated payers.

This is not a remote position.

Responsibilities

• Process initial claims from Therap or other applicable billing platforms by the process of examining, calculating, and or adjusting claims
• Maintain billing platform to ensure accuracy of financials and submitted billing
• Submit claims to payers manually or electronically
• Resolve a high volume of disputed claims by gathering, verifying, and providing additionalinformation, following up on claims
• Monitor collections of receivables
• Monitor and resolve AR report receivables over 90 days old
• Monitor, process, and resolve appeals of receivables
• Monitor filing deadlines for each designated payer and ensure processing is completed in thattimeframe
• Correct claims when errors occur (ex: ICD-10, Authorization number, etc.)
• Collaborate with branch office(s), claims processors, and billing department to ensure collectionand resolve disputes throughout the lives of claims
• Maintain, develop, and update essential billing records
• Assist in preparation of reports required by regulatory agencies as directed by the medicalbilling supervisor
• Gather both private and Medicaid billing information by reviewing consumer records
• Resolve discrepancies by examining and evaluating data, identifying corrective steps
• Enter codes and verify data for computer processing
• Locate and notify designated payers of delinquent accounts by mail, telephone, email, or
• personal visits to solicit payment
• Answer designated payer questions regarding problems with their accounts
• Record information about financial status of designated payers and status of collection efforts
• Perform all other duties as required and assigned by administrator and/or supervisor
• Follow Community Option’s policies and procedures
• Follows federal, state, local laws, and regulations pertaining to home care services
• Create customer accounts and invoices in NetSuite
• Employees must cooperate with the licensee and department staff in any inspection, inquiry orinvestigation
• Additional tasks and responsibilities may be assigned
• High School Diploma or equivalent
• Minimum of two years accounts receivable/billing experience
• Excellent verbal, written, interpersonal, and communication skills
• Knowledge of general accounting principles
• Proficiency in Microsoft Word and excel
• Excellent oral and written communication skills
• State training as required
• Community Options orientation
• Valid driver's license with satisfactory driving record

Working Conditions

• Ability to work in a fast-paced environment, handling multiple priorities
• Occasional overtime is required throughout the year
• Minimal hazards, general office working conditions

Why Community Options?

• Competitive Insurance Benefits (Medical, Dental, Vision)
• Paid Holidays—Including a Birthday Holiday
• Generous PTO
• Employee Incentive & Discount Programs
• 403b Retirement Plan
• Incredible career growth opportunities

Community Options is an Equal Opportunity Employer M/F/D/V

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.