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The role involves overseeing the billing process for various payors/insurers, ensuring accuracy and timeliness in the submission of claims, and managing the billing staff. The job function also includes liaising with insurers to ensure an efficient claims process, managing billing software updates, and interpreting coding and reimbursement guidelines.
Job Responsibility:
Oversight of the submission process for claims to Medicaid, Medicare, NJ Fee-for-service, and other insurers
Supervising and reviewing the work of the billing staff to verify accuracy and promptness
Compilation and uploading of necessary billing data
Interpretation of coding and reimbursement guidelines while staying updated on standards and adhering to contract requirements
Administration of credentialing, enrollment, and contracting of sites with insurers, maintaining access to payor portals
Verification of health insurance coverage and eligibility for behavioral health services
Retrieval, compilation, and research of EOBs
Management of responses to Medicaid and Fee-for-service audits, resolution of discrepancies, and handling of refunds
Providing regular updates on the status of the revenue cycle, including reports and metrics
Acting as a liaison with payors/insurance companies to ensure the claims process is accurate and efficient
Evaluation and analysis of billing processes and procedures to identify trends and areas for improvement
Management of billing software and updates in the Electronic Medical Record, ensuring smooth operation of billing systems and resolution of system issues
Requirements:
Proficiency in Accounting Software Systems
Familiarity with ADP - Financial Services
Experience with Concur software
Ability to handle CRM systems
Knowledge of ERP - Enterprise Resource Planning
Proficiency in using About Time software
Comprehensive understanding of Accounting Functions
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