CSP and Medication Billing Coordinator - Healthcare

Boston Health Care for the Homeless Program; Boston (MA); Vor Ort; USD 31.000 - 49.000; Vollzeit

Benefits dieser Stelle

Health, dental and vision insurance

403B retirement savings plan

Pre-tax MBTA pass with 40% discount

Bilingual proficiency incentive

Time off program

Zusammenfassung

Boston Health Care for the Homeless Program (BHCHP) is seeking a Community Support Program and Specialty Medication Billing Coordinator in Boston, MA. This role handles Third-Party Billing for MassHealth CSPs, including CSP-HI and CSP-JI, along with any specialty medication billing under patients’ medical benefits.

You will oversee claims processing, ensure timely reimbursements, and maintain accurate benefit information while collaborating with clinicians and payers to resolve issues.

Qualifikationen

• 1-2 years work experience in an office setting is required.
• High School diploma or GED certificate is required.
• Some college or post high school training is preferred.
• Health Care Third Party Billing experience is preferred.

Aufgaben

• Reviews bi-weekly specialty medication logs and claims prior to billing; escalates discrepancies to department managers.
• Bill out CSP bill types (CSP, CSP-HI and CSP-JI) daily and monthly along with prior authorizations.
• Process patient claim data into the Practice Management (PM) system promptly and accurately.
• Timely submission of claims generated in the PM system to the appropriate payers following the submission procedure.
• Process payments from third party payers to claims in the PM system precisely and promptly.
• Problem solve denied claims and other non-payment rejections from the third-party payers to attain payment.
• Resolves secondary billing and resubmissions in a timely manner.
• Verify patient benefits to ensure accurate billing and maintain correct benefit information as needed.
• Active and frequent communication with third party provider representatives on billing procedures.
• Interact with clinical staff to facilitate accurate claims processing as needed.
• Perform other billing and administrative related duties as required or assigned by the Patient Finance Manager, Patient Finance Supervisor, and/or Billing Team Leader.

Kenntnisse

Detail-oriented

Organizational skills

Data entry

Microsoft Word

Excel

Access

Effective communication

Multitasking

Ausbildung

High School diploma or GED

Some college or post high school training

Tools

Centricity Practice Solutions

Microsoft Word

Excel

Access

Jobbeschreibung

Who We Are:

Since 1985, BHCHP’s mission has been to ensure unconditionally equitable and dignified access to the highest quality health care for all individuals and families experiencing homelessness in greater Boston. Over 10,000 homeless individuals are cared for by Boston Health Care for the Homeless Program each year. We are committed to ensuring that every one of these individuals has access to comprehensive health care, from preventative dental care to cancer treatment. Our clinicians, case managers, and behavioral health professionals work in more than 30 locations to serve some of our community’s most vulnerable—and most resilient—citizens.

From our earliest days as a program, we have always sought to do work that is transformational: recognizing our shared humanity; centering dignity, compassion, mutual respect and supporting the right of every individual to access the highest levels of health care and every staff member to reach their fullest potential. We continue to be committed to building bridges and breaking down barriers, including systemic racism which harms us all. We provide community-based health care services that are compassionate, dignified, and culturally appropriate, incorporating social determinants of health, with the goal of breaking down the physical and systemic barriers that our patients face.

Job Summary:

Hours: Full-time, 40 hours per week, Monday-Friday
Union: Yes
Union Name: 1199SEIU
Patient Facing: No

The Community Support Program and Specialty Medication Billing Coordinator will be solely responsible for all aspects of Third-Party Billing for MassHealth Community Support Programs (CSP) including general CSP, CSP for Homeless Individuals (CSP-HI) and CSP for Individuals with Justice Involvement (CSP-JI) as well as any Specialty Medication billed under the patients’ medical benefit.

This position oversees the billing process ensuring claims are completed with accuracy and efficiency to ensure timely reimbursement.

Responsibilities:

• Reviews bi-weekly specialty medication logs and claims prior to billing; escalates discrepancies to department managers.
• Bill out CSP bill types (CSP, CSP-HI and CSP-JI) daily and monthly along with prior authorizations.
• Process patient claim data into the Practice Management (PM) system promptly and accurately.
• Timely submission of claims generated in the PM system to the appropriate payers following the submission procedure.
• Process payments from third party payers to claims in the PM system precisely and promptly.
• Problem solve denied claims and other non-payment rejections from the third-party payers to attain payment.
• Resolves secondary billing and resubmissions in a timely manner.
• Verify patient benefits to ensure accurate billing and maintain correct benefit information as needed.
• Active and frequent communication with third party provider representatives on billing procedures.
• Interact with clinical staff to facilitate accurate claims processing as needed.
• Perform other billing and administrative related duties as required or assigned by the Patient Finance Manager, Patient Finance Supervisor, and/or Billing Team Leader.

Qualifications:

Experience and Education:

• 1-2 years work experience in an office setting is required.
• High School diploma or GED certificate is required.
• Some college or post high school training is preferred.
• Health Care Third Party Billing experience is preferred.

Basic Knowledge and Skills:

• Detail-orientated and strong organizational skills are required.
• Strong computer skills in data entry and basic analysis. Familiarity with Microsoft Word, Excel and Access are required.
• Effective communication skills both spoken and written are required.
• Ability to handle and prioritize multiple tasks to meet reasonable deadlines is required.
• Ability to adapt to changes in work procedures is required.
• Familiarity with Centricity Practice Solutions is preferred.

Compensation and Benefits:

• The compensation ranges from $22.25-$35.60 per hour and increases based on years of experience.
• BHCHP full time employees are eligible for our competitive time off program, health, dental and vision insurance, 403B retirement savings plan,pre-tax MBTA pass program with 40% discount, additional compensation for demonstrated bilingual proficiency and more. Benefits are prorated for part-time employees.

Does this amazing opportunity interest you? Then we'd love to hear from you.

As an equal opportunity employer, Boston Health Care for the Homeless Program is committed to providing employment opportunities to all qualified individuals and does not discriminate on the basis of race, color, ethnicity, religion, sex, gender, gender identity and expression, sexual orientation, national origin, disability, age, marital status, veteran status, pregnancy, parental status, genetic information or characteristics, or any other basis prohibited by applicable law.

Covid-19 Vaccination: Proof of Covid-19 vaccination(s) is optional for employment. Candidates who are offered employment will be given details about how to demonstrate receipt of vaccination if they choose to.

Please Note: Employment at Boston Health Care for the Homeless is at-will. Boston Health Care for the Homeless does not sponsor work authorization visas.