Shift: Days, Occasional overtime required.
Workweek: FT 40 hrs/wk
Prepares and transmits patient claims in the appropriate claim format (epaces meditch)
Coordinates and validates claims transmitted to ensure edit criteria is met. Takes appropriate action to follow up when claim fails or requires and edit. (Epaces Meditech)
Consults with appropriate personnel to resolve unbilled claims for Health Home Services. Reviews all bills for reimbursement.
Maintains detailed documentation of billing activities. Maintains documentation of claims processed. Reconciles invoices from down stream providers for upstream and down stream payment for Health home Services
Maintain Health Home data excel spread sheets for daily and monthly patient file tracking and billing claims in the NYS DOH Health Commerce System. Maintain and secure files from down stream providers for submision and correction of error notifications.
Maintains governmental and managed care enrollee rosters. Verifies active coverage & demographic information. Completes monthly mailings and telephonic calls to enrolles with referrals to county care managers. Customer service contact for members to contact. Various data entry scanning in Care Team Connects Software.
Formal Education: Associate Degree or certification equivalent
Experience: 3 years
Skill Requirements: Clerical Secretary,Typing computer , Excel office management, Multitask, Data entry, billing