Program Specialist (Non-Profit) jobs in the United States

Medical Billing Specialist

Seeking a part-time (15-19 hours/week, hybrid), detail-oriented, self-motivated, and highly organized individual with experience in medical insurance and billing. The Specialist will handle all insurance billing, reimbursement, and collection for the organization.

The ideal candidate will possess a high level of professionalism and understand and respect issues of confidentiality. Excellent communication skills, the ability to interact effectively with a diverse team and client base, and the ability to work with a high degree of accuracy and efficiency are also required.

Responsibilities:

§ Timely, accurate submission and processing of insurance claims, payments, and adjustments

§ Review denied medical claims and perform necessary steps for reprocessing until account is resolved

§ Document all follow-up activity taken in the EHR system

§ Verify insurance eligibility

§ Assist clients in understanding medical benefits and eligibility

§ Generate client statements and monthly reports and manage accounts receivables

§ Assist clinicians with insurance paneling

§ Assist with State Licensure requirements and processes

§ Identify payor issues and trends, and escalate those issues to management

§ Monitor risk assessment for HIPAA compliance to best manage risk for
organization.

Qualifications include:

§ Proficient in EHR software with proven experience in medical coding

§ Knowledge of NaviNet

§ Knowledge of Medicare re-validation processes and insurance paneling and credentialing

§ Must possess comprehensive knowledge of medical, ethical, and legal requirements and standards related to healthcare delivery and the privacy of protected client information

§ The ability to be an effective team member.

Job Type: Part-time

Expected hours: 15 – 19 per week

Work setting:

• Hybrid work

Ability to Relocate:

• Princeton, NJ 08540: Relocate before starting work (Required)

Work Location: Hybrid remote in Princeton, NJ 08540