Medicaid & Insurance Billing Specialist

Elmcor Youth & Adult Activities Inc; New York (NY); On-site; USD 55,000 - 63,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401K with match

Paid time off

Sick days

Floating holidays

Gym access

Life insurance

Short-term disability

Job summary

Elmcor Youth & Adult Activities Inc. in St. Albans, NY, seeks a Billing Specialist to ensure accurate, timely processing of claims across Medicaid, Medicare, managed care, and private insurances.

The role requires verifying eligibility, submitting electronic claims through InSync and Inovalon, researching denials, and communicating with participants about balances and payment plans. A strong background in billing software and strong communication skills is essential.

Qualifications

• Bachelor’s degree or over 5 years of experience.
• Knowledge of billing software, (Preferably EPACES, Insync and Inolvalon).
• Good record keeping skills, outstanding communication skills and excellent interpersonal skills
• Must have computer skills and pass a criminal background check.

Responsibilities

• Verify participant’s eligibility for Medicaid, Medicare and private insurances.
• Process Insurance payments to participant accounts in computerized system.
• Pre certify, pre authorize, and obtain authorization for participant SUD billing.
• Submit accurate electronic claims through InSync and Inovalon.
• Research rejected/denied/unpaid claims and complete corrections and follow-up.
• Review remittance and payment info; identify underpayments and posting discrepancies.
• Explain self-pay responsibilities and payment arrangements to participants.
• Monitor self-pay balances and follow up on payment plans.
• Escalate delinquent accounts to Billing Manager and maintain trackers.

Skills

Record keeping

Communication

Interpersonal skills

Multitasking

Education

Bachelor's degree

Tools

EPACES

InSync

Inovalon

Job description

Elmcor Youth & Adult Activities Inc. in St. Albans, NY, seeks a Billing Specialist to ensure accurate, timely processing of claims across Medicaid, Medicare, managed care, and private insurances.

The role requires verifying eligibility, submitting electronic claims through InSync and Inovalon, researching denials, and communicating with participants about balances and payment plans. A strong background in billing software and strong communication skills is essential.