Third Party Specialist/Billing

Third Party Specialist/Billing

Elmcor Youth and Adult Activities, Inc. logo

This position is primarily responsible for complying with all Human Resources Administration- Office of Treatment Monitoring, Medicaid, SSI and Private Insurance requirements and protocols for client enrollments, recertifications, billing and reconciliations for services rendered. This position reports to the Director of Finance.

Essential Duties and Responsibilities:

Core duties and responsibilities include the following. Other duties may be assigned.

  • Completes and submits HRA applications within 3- 5 working days of client admission.
  • Completes and submits re-certification packages as required.
  • Follows up on timely acceptance/rejection of applications, ensuring that eligibility dates agree with application dates.
  • Assists with the ambulatory billing process. Ensures that billing is accurate and timely.
  • Ensures that receivables are accurate and if not, follow up immediately.
  • Provides fiscal department with listing of client’s PNA amounts, in a timely fashion.
  • Assesses and collect client fees, turning them in to the fiscal department as received.
  • Assists clients in obtaining proper ID, employment letters, etc. for HRA requirements.
  • Have Medicaid restrictions lifted and transferred to Elmcor’s medical providers.
  • Handles laboratory and pharmacy invoices.
  • Completes financial assessments and make fee determinations, schedule payments and collect residential client fees. Immediately inform supervisor of noncompliance with fee payments.
  • Ensure that end of the month HRA attestations are accurate and completed in a timely manner.
  • Ensures that STARS reporting of client bed days are accurate.
  • Reports graduations in STARS as required.
  • Remits Medicaid numbers for bills received no later than the end of each month received.
  • Acts as liaison and advocate for clients to resolve billing and Medicaid problems.
  • Provides urine laboratory with a continuously updated listing of client demographics, including Medicaid numbers for billing.
  • Ensures that all clients receive their Medicaid identification cards and makes copies of the same.
  • Ensures that the fiscal department is made aware of all discharged clients so that PNA can be returned as required.
  • Attends all HRA trainings and/or meetings.
  • May be required to work evenings and weekends.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience:

  • Certification in Billing practices or;
  • HS Diploma and 2 years practical experience in billing.
  • Must have computer skills.
  • Must successfully complete a criminal background check, obtain clearance from the Office of Children and Family Services and be drug free.

Employment Type: Full Time

Job Type: Full-time

Pay: $24.72 per hour

Note: All Elmcor employees are subject to mandatory vaccinations per the New York City Vaccine Mandate regulations. All city employees and covered employees of contracted human services organizations must verify that they are fully vaccinated against COVID-19.

To apply for this job email your details to iserveu@me.com