Systems Consultant/Engineering Manager jobs in Brentwood, NY

ABOUT US

Join us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market. ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources.

Position Summary

The Manager of Finance Operations is responsible for finance operational processes within eClaims. 

Essential Functions 

1. Manage the submission and approvals of daily FFS and Capitation check run runs.
2. Manage, track and process all incoming fax, emails and paper EFT requests timely.
3. Analyze claims to ensure they process to the correct category of service.
4. QA, process and upload bank files as required.  
5. Manage timely resolution of Service Care Logs  
6. Manage update claims system with cleared check info and maintain related analysis.
7. Maintain and track all FFS and Claims workpapers.
8. Work closely with IT programmers as needed to enhance processes.
9. Proactively research and monitor industry standards/changes including but not limited to reporting requirements, reimbursement, and benefit changes  
10. Maintain and develop written department policy and procedures.
11. Assist with the year end audit and interact with auditors as needed.
12. Recommend changes within the Finance department to improve/automate processes and procedures.
13. Attend to client service requests and provide client support as necessary.

Education and Experience

• Five years related experience in HealthCare and Accounting
• Five years Management experience
• Five years eClaimns experience.
• Expert knowledge in Microsoft Office software (Word/Excel/Access)
• Knowledge of UB04/CMS1500 claims, ICD9/ICD10/CPT/HCPCS diagnosis and procedure coding required. 
• Medicaid and Medicare reimbursement knowledge a plus.

Required Skills

• Expert knowledge in Microsoft Office software (Word/Excel/Access)
• Knowledge of UB04/CMS1500 claims, ICD9/ICD10/CPT/HCPCS diagnosis and procedure coding required. 
• Medicaid and Medicare reimbursement knowledge a plus.
• Must be detail oriented, organized, and able to work independently. 
• Must have very strong verbal and written communication skills.
• Must be able to analyze data and develop logical solutions.
• Must be able to present data in a clear and professional manner.

EEO STATEMENT 

In compliance with the Drug-Free Workplace Act of 1988, Independent Living Systems has a longstanding commitment to provide a safe, quality-oriented, and productive work environment. Alcohol and drug abuse pose a threat to the health and safety of ILS employees and to the security of the company's equipment and facilities. For these reasons, ILS is committed to the elimination of drug and alcohol use and abuse in the workplace. Independent Living Systems, LLC, and its subsidiaries, including FCC, provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, disability, ancestry, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.