Billing Specialist

Community Options, Inc. is a national non-profit agency providing services to individuals with disabilities in 12 states.

We are seeking a Billing Specialist in Princeton, NJ to be responsible for ensuring Community Options, Inc. is following all aspects and levels of federal, state, and local laws, regulations, and standards within the realm of billing and accounts receivable. The Billing Specialist is responsible for ensuring Community Options, Inc. is in compliance with all aspects and levels of federal, state, and local laws, regulations, and standards within the realm of billing and accounts receivable. This person will collect Medicaid reimbursements by resolving discrepancies, adjusting claims, preparing reports, monitoring collections, and providing excellent customer service to internal staff and designated payers.

This is not a remote position.

Responsibilities

• Process initial claims from Therap or other applicable billing platforms by examining, calculating, and adjusting claims.
• Maintain billing platform to ensure accuracy of financials and submitted billing.
• Submit claims to payers manually or electronically.
• Resolve a high volume of disputed claims by gathering, verifying, and providing additional information, following up on claims.
• Monitor collections of receivables.
• Monitor and resolve AR report receivables over 90 days old.
• Monitor, process, and resolve appeals of receivables.
• Monitor filing deadlines for each designated payer and ensure processing is completed in that timeframe.
• Correct claims when errors occur (ex: ICD-10, Authorization number, etc.).
• Collaborate with branch office(s), claims processors, and billing department to ensure collection and resolve disputes throughout the lives of claims.
• Maintain, develop, and update essential billing records.
• Assist in preparation of reports required by regulatory agencies as directed by the medical billing supervisor.
• Gather both private and Medicaid billing information by reviewing consumer records.
• Resolve discrepancies by examining and evaluating data, identifying corrective steps.
• Enter codes and verify data for computer processing.
• Locate and notify designated payers of delinquent accounts by mail, telephone, email, or personal visits to solicit payment.
• Answer designated payer questions regarding problems with their accounts.
• Record information about financial status of designated payers and status of collection efforts.
• Perform all other duties as required and assigned by administrator and/or supervisor.
• Follow Community Options' policies and procedures.
• Follow federal, state, and local laws and regulations pertaining to home care services.
• Create customer accounts and invoices in NetSuite.
• Employees must cooperate with the licensee and department staff in any inspection, inquiry, or investigation.
• Additional tasks and responsibilities may be assigned.

Minimum Requirements

• High School Diploma or equivalent.
• Minimum of two years accounts receivable/billing experience.
• Excellent verbal, written, interpersonal, and communication skills.
• Knowledge of general accounting principles.
• Proficiency in Microsoft Word and Excel.
• Excellent oral and written communication skills.
• State training as required.
• Community Options orientation.
• Valid driver's license with satisfactory driving record.

Working Conditions

• Ability to work in a fast-paced environment, handling multiple priorities.
• Occasional overtime is required throughout the year.
• Minimal hazards, general office working conditions.

Why Community Options?

• Competitive Insurance Benefits (Medical, Dental, Vision).
• Paid Holidays—Including a Birthday Holiday.
• Generous PTO.
• Employee Incentive & Discount Programs.
• 403b Retirement Plan.
• Incredible career growth opportunities.

If interested, please click Apply Now or Send Resumes to:

Community Options is an Equal Opportunity Employer M/F/D/V.