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 the process of examining, calculating, and or 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 Option’s policies and procedures

Follows federal, state, 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 Requirements

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

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

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.

For further information, please review the Know Your Rights notice from the Department of Labor.