Looking to feed your desire to give to your community and support those who need a helping hand? Look no further! Not only is Preferred Family Healthcare growing the amount of its resources, services, and facilities to assist as many communities as possible, it also provides plenty of opportunity for growth in your current field and the freedom to explore others. Our culture and our environment are unlike any other. We offer highly-competitive pay and a full range of top-notch full-time employee benefits such as:
Medical
Dental
Vision
Life Insurance
Paid Time Off
Short Term Disability
Long Term Disability
Retirement Plan
Tuition Reimbursement
Student Loan Reimbursement
Employee Assistance Program
Job Description:
Essential Job Functions:
Oversee in-house database, assuring up to date entry of all group logs, transfers, discharges and clinical reviews.
Review client’s billable services, monitoring accuracy of the services provided (procedure codes), package authorizations and daily/weekly/monthly limits of services and accuracy of level changes.
Request and track Clinical Reviews from designated program staff ensuring up-to- date entry of requests in a timely manner.
Work closely with Admissions Specialist at designated programs to insure accuracy of admission entry into in-house and external databases.
Maintain and monitor internal designated mechanisms and reports to ensure accuracy/completion of admissions.
Monitor funding sources by completing Medicaid status review at admission, transfer, and at discharge.
Complete daily, weekly, and monthly audits as appropriate for assigned programs, checking billable services for overlaps by clients and providers.
Reconcile invoicing for Accounting Department, including balancing services, client fees/patient responsibility.
Post client fee deductions and non-posted services from invoice into internal database.
Post commercial insurance payments into internal external database that is determined to be “write-off” (clinical review denial, incomplete admission, spenddown/patient responsibility).
Complete submission of billable services to DMH and Medicaid through batch processing based on established cycles and deadlines.
Review claim confirmations, making corrections to billable services or request appropriate information from programs.
Responsible for hand-keying services into database each billing cycle that cannot be submitted through batch process.
Deliver appropriate, timely reports to designated recipients regarding client admissions, discharges, and billable services.
Assist with the development of any new in-house computerized billing systems and client demographic database.
Demonstrates interest in long term and short term goals and objectives of the company.
Other duties as assigned by the Billing Supervisor, Director of Billing, Vice President of Billing, CFO and/or Executive Team members.
Knowledge, Skills, and Abilities:
Considerable knowledge in preparation of all medical claims in billing and electronic billing software.
Ability to obtain necessary documentation
Superior communication and customer service skills
Excellent 10 key and alphanumeric data entry skills with attention to detail
Proficient in common word processing, spreadsheet, database, and web based applications.
Experience and Education Qualifications:
High School diploma with courses in typing and business practices; AND
At least three (3) years experience in a secretarial or bookkeeping position, of which two (2) years includes experience with computers.
Supervisory Requirements:
None
Employment Requirements:
Successful completion of background check including criminal record, driving record and abuse/neglect.
Completion of New Hire Orientation at the beginning of employment.
All training requirements including Relias Learning at the beginning of employment and annually thereafter.
Physical Requirements:
ADA Consideration – Sedentary work: Exerting up to 10 pounds of force occasionally (exists up the 1/3 of the time) and/or a negligible amount of force frequently (exists 1/3 to 2/3 of the time) to lift, carry, push, or pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
We are an Equal Opportunity and Affirmative Action Employer, and encourage applications from all qualified individuals without regard to race, color, religion, sex, gender identity, gender expression, sexual orientation, national origin, age, marital status, disability or veteran status, or to other non-work related factors.
Preferred Family Healthcare is a Smoke and Tobacco Free Workplace.
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