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BILLING REPRESENTATIVE

BRONX, NY, US


The Billing Representative 4C will participate in the patient fee billing and collection system or the Division of Substance Abuse (DoSA) OTP, outpatient addiction, and primary medical care clinics. The Billing Representative will collaborate with clinical staff to obtain all necessary documentation required for billing to Patient, Medicaid, or other insurance and will enter financial data in the program’s billing database and will work to resolve any denied payments.

 

Position Responsibilities / Duties:

  • Collaborate with clinical staff to obtain all necessary documentation required for billing to patient, Medicaid, or other insurances. Enter financial data, including Medicaid numbers, gender, date of birth and other insurance codes into program’s billing database
  • Set all weekly rates using a sliding fee scale and documentation provided by the patient. With appropriate documentation, review requests from the clinic for adjustment of patient weekly fees and balances
  • Determine specific patient fee schedules based on client information and insurance status
  • Review financial assessment performed by clinical staff of all patients upon admission or change in patient’s financial circumstances to determine method of payment for services
  • Identify and contact clinical staff regarding patients who are delinquent in paying for program services
  • Review, process, and monitor billing for claims service claims including OTP, HIV Counseling, Case Management and Testing, HIV Primary Care, Chemical Dependency and patient transportation
  • Utilize professional etiquette in dealing with telephone and personal inquiries regarding billing disputes and possible patient complaints and handle patient billing disputes professionally
  • Ensure billing is scheduled and collections are reviewed on a continuous basis. Maintain contact with program’s billing services, insurance companies, Medicaid, and NYC dept. of finance
  • Compute and submit revenue deposits posted on a general ledger and reported on grants
  • Bill private insurance carriers for patients whose care is reimbursable through these companies. Maintain records of patients with private insurance
  • Prepare and submit claims, re-billing denied claims and back billing claims to Medicaid and other accepted insurances. Maintain database reconciliation. Review denials and enter corrections into billing database
  • Develop reports to track weekly scheduled visits
  • Perform other duties as assigned

 

Qualifications:

  • Must have high level of proficiency with MS Office (Word, Excel), medical databases (EPIC, office ally, IMA), completing claim forms submitting requested information to vendors
  • Must type 50 Words per minute
  • High School Diploma / GED required, medical billing and coding preferred
  • 3 + years of working experience as a Medical Coder (CPC strongly preferred) with insurance verification and authorization is a must
  • Must have strong knowledge of CPT and ICD-10 billing codes and knowledge of Medicaid and commercial insurance billing
  • Must be detail oriented, be able to meet strict deadlines, and have strong customer service skills to be able to interact with patients and industry professionals

 

Department: Psychiatry and Behavioral Sciences Bargaining Unit: 1199 Campus: MOSES Employment Status: Regular Part-Time Address: 1510 Waters Place, Bronx
Shift: Day Scheduled Hours: 9 AM-5 PM Req ID: 106102 

 

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law. 

 

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Mission:
To heal, to teach, to discover and to advance the health of the communities we serve.

Vision:
To be a premier academic medical center that transforms health and enriches lives.

Values
Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

  • Humanity
  • Innovation
  • Teamwork
  • Diversity
  • Equity