Job Description
Job Description
Description :
Nexus-Woodbourne is seeking a detail-oriented Medical Billing Specialist with proven experience in Medicaid billing, collections, and payment processing. The ideal candidate will ensure accurate claim submissions, timely reimbursements, and compliance with state and federal healthcare regulations.
At Nexus Family Healing, we embrace diversity, promote equity, and foster inclusion. As a national mental health organization, we serve a diverse group of youth and families, and we strive for our workforce to support and represent that diversity.
Schedule / Location / Pay :
Salary Range - $25 - $28 per hour
Full Time - On-site opportunity (1301 Woodbourne Ave Baltimore MD)
Nexus’ Comprehensive Benefits Include :
- Paid Time Off (PTO) benefits in the amount of 56 hours (7 days) will be issued as a lump sum at the beginning of the calendar year or calculated as a pro-rated amount if hired mid-year.
- Additional 1 Floating Holiday
- Multiple options for health insurance coverage
- No-cost life insurance
- Short / long-term disability insurance
- 401k match
- NEW – Talkspace Therapy Benefit for the whole family
- NEW – Hinge Health Benefit for the whole family
- NEW – Carrot Fertility Benefit
- Tuition assistance and training opportunities
- Advancement pathways and internal promotion
- And much more!
Position Summary : The Medical Billing Specialist is responsible for ensuring timely and accurate claim authorization, processing and accounts receivable management of client Electronic Health Records by performing coding and billing tasks on a computerized health information technology (HIT) system, while assuring payments related to client services from all sources are recorded and reconciled timely in order to maximize revenues.
Primary responsibilities :
Record ComplianceMaintains accurate and legally compliant medical records of patient demographic information and medical diagnosis coding for accurate claims processing.Manages accounts receivable billing and collection of payments in order to meet and maintain financial reimbursements expected.Prepares, corrects, audits, and submits claims to third-party payers.Monitors and reacts to aging accounts for collections requirements.2. Claim Authorization, Reconciliation, Collections & Provider Liaison
Collecting clinical paperwork and communicating with clinical staff regarding authorization needs.Reviews denials or partially paid claims and work with the involved parties to resolve the discrepancy. c. Completes outbound invoicing and collection calls.Acts as intermediary between healthcare providers, clients, and health insurance companies as needed.Reviews insurance payments for accuracy and compliance with contracts.Consults with supervisor, team members and appropriate resources to solve billing and collection questions and issues.3. Program Compliance
Prepares reports and forms as directed and in accordance with established guidelines.Complies with all company policies, related laws and regulations pertaining to the position and for fulfilling the obligations under HIPAA, COA, Medicaid and other state and federal entities as required.Functions as contributing team member while meeting deadlines and productivity standards.Remains current on all company policies, assigned trainings and / or certification requirements. e. All other tasks and duties as assigned.ICARE Values & Behavioral Competencies :
Innovation : Leading the way and implementing creative, cutting-edge ideas and approaches.Compassion : Listening, honoring differences, and showing respect, kindness, empathy care, and concern.Agility : Exhibiting flexibility and adapting quickly.Responsiveness : Being quick, positive, and accurate.Excellence : Demonstrating quality results that surpass ordinary standards.Commitment to Diversity, Equity, & Inclusion :
At Nexus Family Healing, our voices and actions will be focused on recognizing, affirming and respecting people of every race, ethnic background, socio-economic status, sexual orientation, gender expression and faith.
Keywords : “Medical Billing Specialist", "Payments", "Collections", "Medicaid", "Medicaid Billing Collections", "Medicaid Billing Payments", "Medicaid Insurance", "Medical Biller"
Requirements :
Required Education and Licensure :
High School Diploma or equivalentKnowledge of accounting and basic book-keeping practices and reporting.Understands medical terminology, billing software and electronic medical records.Knowledge of insurance claims processing, rules and guidelines; especially for Medicaid reporting requirements.Proficiency in Microsoft Office Suite and data entry skills required.Educated on and compliant with HIPAA regulations; maintains strict confidentiality of patient and client information.Ability to work effectively within role independently and with other team members.Ability to organize and complete work in a timely manner.Ability to read, write and communicate effectively.Valid driver’s license required. Must meet state regulating agency and Home Office driving requirementsPreferred Education and Experience :
Associates Degree in Business Administration, Accounting, or other Healthcare related field.Certified in Medical Reimbursement Specialist (CMRS).A minimum of two (2) years’ experience in healthcare billing and collections as a Medical Biller or similar role.Experience with Medicaid’s State Eligibility System.