The Billing Data Coordinator is responsible for identifying issues and facilitating corrections for anything preventing events in the E.H.R. system from moving to clean claim status by working with all programs/departments especially Billing Data, Billing and Authorizations. The Billing Data Coordinator is responsible for continued follow up on all TPLs processed. The Billing Data Coordinator is to be cross trained in specific Finance areas, especially Billing Data and Authorizations for back up support. The Billing Data Coordinator is responsible to provide support in all phases of client billing for all funding sources, including TPLs, posting of remittances, cash and accounts receivable Follow-Up.
1. Generate / print an event issue report on a daily basis to assist in the billing process. This report identifies services that cannot be billed due to various errors. Correct and/or contact program staff, if applicable, to correct errors. Errors need to be reconciled as quickly as possible, if unable to do so within 3 days, notify the Supervisor.
2. Must be proficient in CPT codes, ICD 9/10 and continue to remain abreast of all related revisions and updates.
3. Support for Cash application – this is accomplished manually for some payers and electronically for others.
4. Back up support for EVS batch runs. As necessary assists with training program administrative staff.
5. Back up support to the Authorization Specialist.
6. Must be familiar with credentialing needed for all insurances to effectively communicate with program.
7. Generate and/or work with payer rejections as assigned. Review denials and take appropriate action for resubmission and/or appeal. Report to Supervisor and other Billing Staff if denials could not be resubmitted (at least weekly.)
8. Process, generate and upload claims to identified funding sources. There are different processes for various insurance companies, each has its own deadline. Process TPL claims as directed. Research insurance coverage as necessary. Constant follow-up calls and claim status calls to Third Party Insurance and Government Insurance (CBH).
9. Print or manually complete statements/invoices for all insurances as assigned.
10. Remain current with all regulations from CMS/Federal, Medicaid/CBH/State/Local and other funding sources regarding submission and payment of claims.
11. Participate in weekly meetings to reduce lost revenue, participate in monthly Finance meetings to reduce write-offs.
12. Other duties as assigned, including special projects, re-assignments, etc.
13. Must function in full compliance with all applicable policies and procedures, federal state and local laws and Interact’s Code of Conduct. Must participate in Interact’s Compliance Program including reporting suspected violations of the compliance program or applicable laws or regulations to supervisor/manager/director or the Compliance Officer.
14. Must participate in Interact’s Quality Improvement activities as requested by supervisor/manager/director or Quality Assurance Department
15. Adheres to safe work practices
1. Minimum 10 years of experience, preferably as a biller in a Philadelphia, non-profit, behavioral health setting, with knowledge of electronic billing and electronic remittance advice.
2. Third Party Liability billing experience.
3. Strong ability to multi-task and set priorities.
4. Highly detailed oriented.
5. Proficient in Excel and E.H.R systems.
6. Strong interpersonal skills & ability to handle difficult situations.
Intercommunity Action, Inc. is an EO Employer – M/F/Veteran/Disability
Interested candidates may forward their cover letter and resume to:
Intercommunity Action, Inc.
6122 Ridge Avenue
Philadelphia, PA 19128
email@example.com (email preferred)