Third Party Billing Specialist

  • Milford, MA, USA
  • Full-time

Company Description

Human Services Management Corporation (HSMC) provides shared business and consulting services to both non-profit and proprietary human services agencies. These services include accounting, payroll, third-party billing and collections, human resources, online and live Continuing Education, marketing, facility development and quality assurance programs.

Job Description

HSMC is currently seeking a Third Party Billing Coordinator!

Responsibilities

  • Perform coding and billing tasks on a computerized health information technology (HIT) system.
  • Utilize a combination of electronic health record (EHR) and paper patient records to perform billing duties; maintain an accurate, legally compliant medical record. 
  • Submit insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
  • Follow up and resubmit claims in a timely fashion.
  • For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary insurer
  • Follows HIPAA guidelines in handling patient information.
  • Make necessary arrangements for medical records requests, completion of additional information requests, etc. as requested by insurance companies.
  • Respond to inquiries from insurance companies, patients and providers.
  • Regularly meet with Intake and Collection Specialist to discuss and resolve reimbursement issues or billing obstacles.
  • Perform additional duties as requested by Supervisory or Management team.
  • Other reasonably related duties as assigned by the Director of Professional Billing, Associate Vice President of Revenue Cycle, Vice President of Financial Operations and/or the President.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 EDUCATION

Successful completion of a program in medical billing; current Certified Medical Reimbursement Specialist (CMRS) certification; or Associate’s Degree in Business Administration, Accounting, Health Care Administration or related field.

WORK EXPERIENCE

5 years’ experience in a high volume medical billing role, Experience in CPT and ICD-10 coding; familiarity with medical terminology preferred.   

COMMUNICATION SKILLS

Expressing or exchanging ideas by means of the spoken and written word required.  Those activities in which the individual must convey detailed or important spoken or written instructions and information to students, their families, staff, management personnel and public safety officials, accurately, loudly, or quickly.  Must be able to communicate effectively.   The ability to speak clearly and concisely, and to convey information or articulate an opinion is essential for this position. Must be comfortable speaking / presenting to an individual or to groups. The ability to convey your message in writing using proper grammar is a basic requisite for this position.

MATHEMATICAL SKILLS

Knowledge of arithmetic and their applications, and ability to perform these mathematical operations.

REASONING ABILITY

Ability to carry out instructions furnished in written, oral or diagram form.  Ability to tolerate interruptions and still be able to prioritize and focus to meet standards of quality in accuracy, attention to detail and time constraints. Ability to learn policies and procedures and apply them to various circumstances including the ability to interpret needs and respond in standardized situations. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.  Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

OTHER SKILLS/REQUIREMENTS

Availability to work nights, and early mornings, and/or to travel on an as needed basis.  Computer experience is essential, including, but not limited to: practice management software, and MS Office applications.

CERTIFICATES, LICENSES, REGISTRATIONS

Not Applicable

PHYSICAL DEMANDS

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Hearing.  Perceiving the nature of sounds at normal speaking levels with or without correction.  Ability to receive detailed information through oral communication and to make discriminations in sound.

Sedentary Work.  Exerting up to 40 pounds of force.  Sedentary work involves sitting most of the time.  

Visual Acuity.  The employee is required to have close visual acuity to perform an activity such as:  preparing and analyzing data; viewing a computer screen, extensive reading.  

While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms.  The employee may be required to periodically stand, walk, sit, stoop, kneel, or crouch.  The employee may be required to occasionally climb or balance.

 WORK ENVIRONMENT:

The employee is not substantially exposed to adverse environmental conditions.

SUPERVISION/REPORTING:

The Third Party Billing Coordinator reports directly to the Director of Professional Billing.

Additional Information

OUR BENEFITS:

  • Medical & Dental Insurance
  • Flexible Spending Plan
  • 401k with company contribution
  • Voluntary Benefits
  • Paid Time Off (Sick, Vacation, Holidays)
  • Tuition Reimbursement
  • Staff Events (Foxwoods, NYC, Six Flags)

Please visit our website at www.hsmc.org to learn more about our organization!

Selection for employment is made regardless of race, color, religion, creed, sex, sexual orientation, gender identity/expression, pregnancy or pregnancy-related condition, marital status, national origin, ancestry, age, disability, handicap, genetic information, someone who is a member of, applies to perform, or has an obligation to perform, service in a uniformed military service of the United States, including the National Guard, on the basis of that membership, application or obligation; veteran status, or any other bases protected by law. HSMC participates in E-Verify.