The McCarton Foundation is a non-profit organization on a mission to bring exceptional treatment and services to children with autism. We believe in the ability that exists within every child who has autism, and that all children deserve the opportunity to reach their full potential. Over the past two decades we’ve transformed the lives of thousands of children from around the globe through the McCarton Center for Developmental Pediatrics, the McCarton School for children with autism, and the Children’s Academy for children with speech and language learning delays. We utilize the McCarton Integrated Model, which combines speech and language therapy, fine and gross motor therapy, sensory integration therapy, socialization with peers, developmental play skills and applied behavior analysis (ABA) therapy.
In 2018 the McCarton Foundation will begin providing services for infants and toddlers diagnosed with autism in our new facility, The McCarton Achievement Center in the West Farms area of the Bronx. Our new center will provide services to young children at no cost to families through the Early Intervention Program. We are excited to be able to bring our exceptional method of treatment to children from low-income families in our city’s most underserved communities.
The McCarton Achievement Center is currently seeking an Early Intervention billing specialist to perform billing and daily operations.
POSITION SUMMARY
Under the supervision of the COO this position administers billing processes for the organization. Monitors billing policies and procedures to improve efficiency and effectiveness of practices. Stays informed regarding changes in commercial insurance coding and billing as well as changes to the Early Intervention Program’s billing policies and those of Medicaid.
Responsibilities
- Accurate data entry review and use of the centers software to ensure that billing is compliant with EI billing standards
- Submit subrogation letters for insurance companies
- Verify and update the correct amount to charge for the services rendered, and the procedures administered
- Input and ensure accuracy of all NYEIS and eMedNY data
- Handle all Remittance issues and report reporting EOBs to SFA
- Assure HIPAA compliance with regards to billing practices
- Submit billing via manual data entry in the NYEIS system and/or uploading HIPAA 837 P Electronic Files
- Contacting insurers and talking to parents about insurance.
- Maintain knowledge of all coding regulations, particularly as it relates to assigned state or payor
- Serve as a liaison between our center and insurance providers
- Billing payment posting
- Collection calls
- Managing claim resubmissions
- Oversee aging reports and follow-up on payments of claims and EOBs
- Alphabetize, scan, and file confidential documents to maintain service record
- Quality assurance review of documents to ensure that each file is complete - review session notes daily, check for accuracy prior to billing.
- Follow up with staff to get corrections done on a timely basis
- Ensure accurate reimbursement from insurance on all claims.
- Assume responsibility for managing receivables and cash conversion cycle-
Requirement/Qualifications
- Must have prior experience with Early Intervention billing
- Experience with ABA, physical, occupational, speech therapy and other EI services CPT and ICD codes
- Current knowledge of insurance terminology and coding
- Understands Medicaid regulations and guidelines
- Experience billing and collecting Medicaid claims
- Knowledge of filing claims using HIPAA 837 P Electronic Files
- Understanding of handling billing issues with The Child Health Plus program, Medicaid Managed Care plans
- Knowledge of how to deal with regulated and non-regulated insurance companies in relation to EI billing
- Experience and in-depth knowledge of eMedNY bill processing
- Must have experience with medical posting and billing platforms for private insurance companies
- Must have experience with BEI and NYEIS systems and managing NYEIS Invoices and Claims
- Assertive personality, strong problem-solving skills
- Prior experience with provider soft is a plus
- Excellent organizational and time management skills
- Passionate about our mission in providing quality no cost services to families
- Must have at minimum a High School Diploma, Associate's degree is a plus