CSP & Specialty Medication Billing Specialist

Boston Health Care for the Homeless Program; Boston (MA); On-site; USD 31,000 - 49,000; Full time

Benefits offered by this job

Health, dental and vision insurance

403B retirement savings plan

Pre-tax MBTA pass with 40% discount

Bilingual proficiency incentive

Time off program

Job summary

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.

Qualifications

• 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.

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.

Skills

Detail-oriented

Organizational skills

Data entry

Microsoft Word

Excel

Access

Effective communication

Multitasking

Education

High School diploma or GED

Some college or post high school training

Tools

Centricity Practice Solutions

Microsoft Word

Excel

Access

Job description

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.