Full-Time Billing Specialist

Swank Early Skills Development

Lancaster, PA

$19 to $21 Hourly
Vision , Medical , Dental , Paid Time Off , Life Insurance , Retirement
Full-Time

Job Description

Swank Early Skills Development is seeking an experienced Billing Specialist to join our team at our Lancaster, PA Center!

Seeking a professional with at least 1 year experience working in the medical billing profession. Experience in medical billing for Behavioral Health or Applied Behavior Analysis (ABA) for commercial insurance and Medical Assistance (MA) are not required but helpful.

Compensation:

Competitive hourly pay rate $19-$21 depending on training and experience
Paid Time Off- accrual based
10 paid holidays annually (9 company holidays and 1 floating holiday)
Performance-based raise opportunities
Intermittent bonuses
Informal Profit-Sharing
Company incentive program
Company referral bonuses

Benefits:

Medical Insurance – with a percentage employer premium contribution towards employee premium
Dental Insurance
Vision Insurance
Life Insurance*
Short Term and Long Term Disability*
Simple IRA Retirement Plan with Company match- for qualified employees who enroll

*designates a company-paid benefit

Essential Functions and Responsibilities:

Submit insurance claims (primary, secondary and tertiary) across appropriate funder portals at least weekly and within required “timely filing” guidelines to ensure consistent revenue cycle
Monitor claim denials, resolutions and resubmissions
Monitor outstanding claims balances and outstanding revenue
Create, send and follow up on invoices in order to collect financial obligation of the client
Obtain, maintain, and distribute information about prior authorization for client services to clients, clinicians and operations team members
Enter authorizations in designated client tracking system
Provide support to the greater operations and clinical team members with authorization updates, claims status reports and outstanding revenue reports
Process initial benefits verifications and communicate with families regarding findings
Monitoring client active benefits through EVS checks
Assist families with coordination of benefits
Maintain information on claims processing procedures and step by step guidelines for claims monitoring for all funders
Secure SESD’s ability to do business with Private Health Insurance companies and Medical Assistance
Monitor claims payments and ensure that rates paid align with funder fee schedules
Works independently to ensure streamline processes and ensure

Other Required Skills and Abilities:

Works collaboratively with other members of the Operations Team to ensure cohesive and efficient processes and outcomes.
Uses strong problem-solving skills and takes initiative to provide solutions for barriers to providing services to our clients.
Multi-tasks and shifts easily between various tasks as needed, following up on unfinished projects in a timely manner
Handles sensitive company documents and information with the utmost privacy and security as per company procedures, following both HIPAA and FERPA regulations as they apply.
Demonstrates the ability to effectively and efficiently use Microsoft Office Word, Excel, and other Office Products in the engagement of data collection, tracking, report writing, and other activities that are needed in this role.
Demonstrates the ability to quickly learn and begin to use other software required for the execution of business in the company as it arises.
Demonstrates the ability to effectively and efficiently manage documentation systems related to contract fulfillment, contract compliance, invoicing, and payment processing.
Demonstrates excellent verbal and written communication skills: the ability to communicate professionally, and positively with coworkers, clients, and contacts that the company receives from the outside.
Effectively communicates with potential clients, clients, business associates, and co-workers with positivity and compassion through all means of communication.
Handles challenging conversations with clients and insurance providers with positive firmness and respect.
Effectively decides when situations need to be elevated to ACOM, COM or other members of management depending on nature of concerns or situation.

Physical Demands of Role

Using a physical key to unlock and lock Company doors, filing cabinets, and other locked
storage facilities or devices.
Looking at a computer / electronic device screen for most of the workday.
Typing / keyboarding for most of the workday.
Sitting at a computer for most of the workday.
Vocally communicating with people frequently throughout the workday.

Minimum Qualifications

High School Diploma/GED required (College Degree preferred)

At least one(1) year of continuous and proven experience as a medical billing specialist, preferably in a Behavioral Health environment
Strong mathematics skills and a good command of the English language
Ability to process financial information quickly and accurately
Strong knowledge of health insurance providers, including medical assistance
3 positive professional reference checks, including one from former/current direct supervisor
Can produce “clear” PA required clearances (PA Child Abuse Clearance, PA State Criminal Check, FBI Fingerprint Clearance) valid within 1 year of hire date
TB Test
Mandated Reporter training
Proof of Eligibility to work in the U.S.

Other Preferred Qualifications (not required) which will be considered in the starting hourly rate offer:

Certified in Billing and Coding
College degree or further education in the skills required for the role
Experience in Behavioral Health or Applied Behavior Analysis (ABA) billing and authorizations

Come Join Our Team!

Swank Early Skills Development LLC is an Equal Employment Opportunity/Affirmative Action Employer and does not discriminate on the basis of race/color, religion, sex, sexual orientation, gender identity, national origin, medical history, protected veteran status, disability or any other legally protected status.

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