East Bay Community Action Program (EBCP) is seeking a Billing and Collections Specialist Senior in East Providence at 100 Bullocks Point Avenue. Under general supervision of the Director of Finance & Revenue Cycle, Senior Billing & Collections Specialists are responsible for timely submission of claims to maximize billings and collections from a wide variety of medical, behavioral health, and/or dental providers and locations, as well as monitoring and ensuring payments for clinical services are received in a timely manner.
Work directly with peers, leadership, providers, and staff to ensure success of business strategies, compliance plans, and work-flow improvements related to billing & collections.
Utilize EMR, PM, and Clearinghouse data to analyze and work assigned A/R, such as: identifying, working, and minimizing preventable rejections, Return to Providers, denials and write-offs
Ensure that all balances are billed to the responsible payor, this includes correcting eligibility on encounters erroneously assigned to A/R; communicate these instances to the responsible biller to ensure that claims will be billed to the correct payer within timely filing limits
Ensure accurate patient balances (coinsurance, deductible, etc.) Apply sliding fee scale for eligible patients (when appropriate)
Complete and submit credentialing applications/re-applications to contracted Managed Care Organizations (MCO) in a timely basis, to maximize patient access to care, and minimize financial liability of non-reimbursable services provided. Maintain individual clinician credentialing files. Obtain all licensing/certification/educational information from applicants/staff/Director of Compliance & Credentialing as necessary to complete submissions.
Follow-up on all applications/re-applications sent to clinical staff for completion. Review for accuracy and completeness prior to submission to MCO. Maintain contact with MCO regarding progress of application/re-application.
Minimum Required Education- High school diploma or equivalent required Five (5) or more years previous experience as a Billing & Collections Specialist in a healthcare environment, preferably an FQHC with progressive responsibility. Certified coder a plus Previous experience credentialing clinical staff with managed care organizations a plus.
For Full Time Employees Working 30 – 40 hours per week, EBCAP provides a comprehensive compensation and benefits package that includes heavily subsidized medical and dental insurance plans (BCBSRI), supplemental vision insurance, voluntary medical and dependent care flexible spending accounts, up to 3% company matching 403(b) retirement plan, employer-paid life insurance & long term disability, generous paid time off that includes vacation/holidays/personal days/sick time, mileage reimbursement, tuition reimbursement, opportunities for center-paid training/CEUs, employee assistance program, discounts to local businesses and services, such as Work Out World New England, YMCA/Newport, BJ’s Wholesale Club, cellular services, and so much more!
EBCAP is an equal opportunity/affirmative action employer committed to providing a diverse work environment.
To apply for this job please visit ebcap.clearcompany.com.