Billing Coordinator

Sun River Health provides the highest quality of comprehensive primary, preventative and behavioral health services to all who seek it, regardless of insurance status and ability to pay, especially for the underserved and vulnerable. Sun River Heath is a Federally Qualified, Non-Profit Health Center serving communities in Suffolk, Rockland, Orange, Dutchess, Ulster, Sullivan, Columbia and Westchester County. Sun River Health is currently seeking a full-time remote Billing Coordinator in support of Skyward Health, an affiliate of Sun River Health.

Skyward Health is a designated New York State Health Home that provides oversight to over 60 Care Management Agencies in Long Island, NYC and the Hudson Valley. Health Homes are responsible for billing, quality oversight, compliance, technical assistance, etc. for the agencies that work with our members to overcome health, social and financial challenges. Our mission is to improve lives and drive value.

Position Summary: Provides billing and fiscal support to the Health Home department inclusive of monitoring member and contractor transactions, overseeing statement generation, payments, follow-up and Account Receivable reconciliation with payers. Will interface with other support contractors as necessary (i.e. external finance department and EHR vendor). There is also limited data processing support to the Health Home department.

Responsibilities include:

· Transmit data to outside parties (Payors, vendors, contractors, etc.) as necessary through secure communication methods to ensure HIPAA confidentiality is maintained.

· Reconcile generated claims vs potential claims and other payment, denial and outstanding claim information

· All documentation created and/or transmitted is as correct as reasonably possible

· Monitor the status of claims in the EHR, acting on posted claims decisions from payers (or lack of responses from payers) as appropriate

· Access, as needed, state policies, insurance portals, clearinghouses, etc. to review EOBs or other documents to assist in claims reconciliation

· Handle all billing inquiries from internal and external parties, inclusive of rate changes, policy changes and HCBS & HHSC specific billing matters

· Consult on member insurance eligibility as needed

· Identify and correct rejected claims, using all needed platforms for information

· Consult-on/create/review and act on billing reports such as an Aging Accounts Receivable, Billing by CMA, MCO Payment Summary, etc.

· Resolve all billing issues and disputes by contacting insurance companies directly and, as a secondary action, involving and holding-accountable the EHR vendor as needed

· Perform scheduled data management/updating activities on a regular basis

· Reconcile MAPP tracking errors (as related to billing/documentation)

· Facilitate CMA Tracking/Billing Support Programs as created

· Attend all MCO meetings, bringing up high-level billing concerns as needed and relaying non-billing information to manager

· Create and/or deliver billing updates to the CMA/Contractor network as needed, usually through Webinars or Newsletters.

· All other responsibilities as assigned.

Education: High School Diploma or GED required, Bachelor's Degree Preferred

Work Experience: Minimum 2-4 years

Required Specialized Skills & Knowledge:

· Solid knowledge and understanding of billing concepts, billing codes, medical terminology, healthcare billing, and Electronic Medical Records. Ability to read and work with EOBs.

· Ability to communicate in English, both orally and in writing

· High level of competency in work processing skills (MS Word Suite)

· Possesses excellent interpersonal and communication skills.

· Ability to collaborate with other members of Skyward Health.

· Ability to collaborate with contractors (External finance department, EHR vendor, etc) and payers (Managed Care Organizations, eMedNY, etc)

· Possesses the emotional, mental and physical capability to perform duties and shows strong commitment to achieve goals

· Ability to organize work effectively, accept and utilize guidance and work cooperatively

· Possesses flexibility, cultural sensitivity and ability to maintain confidentiality

Sun River Health is a network of over 40 Federally Qualified Health Centers (FQHCs) providing primary, dental, pediatric, OB-GYN, and behavioral health care to over 245,000 patients annually. With a dedicated staff of 2,000 doctors, nurses, and health care professionals, we pride ourselves on delivering high-quality, affordable care to those who need it most. Sun River Health started in 1975 when four African American mothers spearheaded efforts to open our first health center in Peekskill, New York to deliver accessible, high-quality, affordable services to patients in need no matter their race, religion, income, or insurance status. Today, after 45 years of service, Sun River Health is still delivering on that promise to communities across the Hudson Valley, New York City, and Long Island.

Job Type: Full-time

Pay: $26.37 - $30.22 per hour

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance
• Work from home

Schedule:

• Monday to Friday

Application Question(s):

• Please note this is a full time M-F position with benefits that starts at $18ph and can increase based on experience. Please indicate your desired starting rate.
• Sun River Health requires COVID vaccination or valid medical exemption.
• Must reside in New York State.

Education:

• High school or equivalent (Required)

Experience:

• Medical billing: 1 year (Required)

Work Location: In person

Salary : $26 - $30