Billing Specialist/Revenue Support

Paterson Community Health Center   Paterson, NJ   Full-time     Finance
Posted on February 9, 2024

Health Care Staff Needed at the Paterson Community Health Center, a provider of primary family healthcare services to some 5,000+ patients- Ob/Gyn, Pediatrics, Adult Medicine, Podiatry, and Dental; dedicated to meeting the healthcare needs of the Greater Paterson New Jersey Community

The Role: The Billing Specialist/Revenue Support will support various functions of the clinic, including securing real-time insurance benefits eligibility and coverage information for patients, following up on rejected/outstanding claims, and collaborating with third-party partners on data and clarification requests.

What You'll Bring:

  • Verifies detailed insurance benefits, medical necessity, and authorization/referral guidelines, consistently prioritizing and following the established verification process
  • Read and interpret insurance Explanations of Benefits (EOB)/Remittance Advice (RA) with understanding and take appropriate steps to resolve issues.
  • Verify all information obtained is correctly documented in the patient's account, in the correct format.
  • Communicate with insurance providers via phone and electronically via web portals to validate patient benefits, check authorization requirements, and review authorization status.

Billing/General

  • Review regular data feeds from third party billing partner and research patient insurance coverage and billing status using internal and external tools.
  • Create and utilize spreadsheets and other tools to track visit statuses and contracting/credentialing data.
  • Ensures compliance with all Health Insurance Portability and Accountability Act (HIPAA) standards.
  • Performs other duties as required or assigned within the scope of responsibility, including supporting other functions and teams within Revenue Operations.

What excites us:

  • Passionate for our mission to transform healthcare for all children
  • 2+ years experience in insurance verification with experience in Medicaid, Managed Medicaid and commercial payers across multiple states. Experience with California and Florida Medicaid strongly preferred.
  • 1+ years or more experience with Google Suites (google sheets, google docs)
  • 1+ years experience with Change Healthcare or other online eligibility healthcare tools
  • 1+ years experience with claims adjudication/follow-up
  • Experience navigating state Medicaid, Managed Medicaid, and commercial insurance portals
  • Highly detail-oriented and comfortable with insurance, claims, and other data sources
  • Ability to understand how job performance affects the outcomes of key performance indicators such as billing rates, denials, and write-offs.
  • Self-motivated with excellent decision making and time management skills
  • Ability to meet remote work expectations, including but not limited to active participation in virtual meetings and real-time communication via Slack
  • Exceptional communication and collaboration skills, especially in a virtual work environment.

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Mission Statement

The mission of the Paterson Community Health Center is to provide quality and respectful health care to the greater Paterson community, especially to the uninsured and underinsured.

We strongly believe that no one should be without quality healthcare.
No one turned away from care because of their inability to pay.
All are welcome regardless of immigration status

Board of Directors
While the Paterson Community Health Center, Inc., is a privately owned, 501(03, non-profit organization, it receives significant funding from the Federal Government and thus is designated as a Federally Qualified Health Center (FQHC). As an FQHC organization the health center is requested to ensure that the majority of the health center’s Board of Directors are health center patients. The health center’s Board is (representative) of the health center patients and the Paterson, NJ community. By race and ethnicity, the board members are African-American, White, Latino and Middle Eastern. The board members bring to the health center a wealth of knowledge and experience in the fields of law, public safety, business, finance, health care and social services.