Third Party Billing Specialist - #19503960

Community Healthcare Network


Date: Dec 26, 2020
City: New York, NY
Contract type: Full time
Community Healthcare Network

Community Healthcare Network is seeking for a Full-time Third Party Billing Specialist who under the direction of immediate supervisor, perform accurate weekly billing cycle functions to maintain and support third party revenue cash flow.


JOB FUNCTION:


Responsibilities include, but are not limited to:




  1. Daily, create, review and edit claims, for all Health Center Clinic sites, for completeness and accuracy before claim submission.




  2. Daily, complete insurance eligibility verification via all methods available to include, but not limited to, e-Paces, insurance payer portals and update the patient profile as needed.




  3. Effectively communicate with Health Center Clinic management and staff to resolve Level 1 billing issues.



  4. Responsible for managing accounts receivable, as assigned by management, to include but not limited to:



  • Daily, review and correct vendor claim rejection reports, electronic remittance advice and explanation of benefits.

  • Follow-up with insurance payers on unpaid and denied insurance claims.

  • Research and update address for returned mail.

  • Follow up on patient and insurance refund requests.




  1. Facilitate related services for health center patients and Health Center Clinic staff as appropriate, with respect to their confidentiality and privacy.



  2. Perform other related duties, as assigned by management.


What We Look For:



  • Associate Degree with two (2) years of college Medical billing courses, one (1) year experience in Medicare Outpatient billing or the equivalent experience.

  • Familiarity with computerized billing applications and spreadsheets.

  • Knowledge of CPT and ICD9/ICD10 coding.

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