We need hope-bringers and changemakers — because the work we all do matters.
If you’re passionate about making an impact with your time and being someone’s light in the darkness, we want you on our team. Come Join Us to Do Mission-Based, Meaningful Work Who We Are Gaudenzia is one of the largest nonprofit providers of treatment to people with substance use and co-occurring disorders in the nation. We operate in Pennsylvania, Delaware, Maryland, and Washington, D.C. Our caring, compassionate team is on a mission to save thousands of lives each year and bring hope to people devastated by substance use disorder.
Together, we help individuals, families, and communities heal and thrive in the face of one of the most devastating public health crises of our time. As our organization grows and evolves to meet the needs of our clients and communities, we’re seeking passionate, empathic individuals to help us make an impact. With your help, we can turn the tide on substance use disorder.
Who we’re looking for: The Billing Specialist reports directly to the Revenue Cycle Manager and is responsible for providing support, covering all aspects of insurance billing, claims follow up and collections, including direct contact to the appropriate third-party payers for all unpaid claims including denied claims and those requiring appeal. The Billing Specialist supports the Revenue Cycle Manager for the overall billing, receivables, and collections for Gaudenzia Inc., and all related entities. The ideal candidate will be organized, experienced with medical billing, collections, and accounts receivable. Employees are expected to exercise initiative, independent judgment, and critical thinking in completing their duties.
Your responsibilities in this role may include:
- Ensures optimal revenue recognition for all program locations through the entire organization.
- Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
- Process payer EOBs and 835 files.
- Work EDI transactions and Electronic Remittance Advice (ERA) files including reconciling carrier submissions edits and rejection reports.
- Handling and interpreting medical documentation such as UB04 claim form, 1500 claim forms and EOB’s.
- Provide effective and accurate processing and posting of insurance payments; both manually and/or electronically.
- Responsible to maintain and resolve the day-to-day billing and cash collections issues; follow up on unpaid claims and file appeals when appropriate.
- Ensure batch balances following completion of posting payments. 8. Receive/research potential refunds, write-off codes, and credit transfer.
- Review and research denied claims by navigating multiple computer systems and platforms, in order to accurately capture data / information for processing.
- Verifies Medicare, Medicaid and Commercial benefits and prior authorizations.
- Work with commercial, managed care, Medicaid and Medicare providers.
- Focus efforts on decreasing the Accounts Receivable, increasing cash, and / or reducing bad debt
- Maintain strict confidentiality; adhere to all HIPAA guidelines/regulations.
SKILLS, KNOWLEDGE, AND ABILITIES
- Demonstrates expert use of applications such as Word, Excel, and PowerPoint in written reports.
- Ability to work effectively with all levels of management
- Working knowledge of billing audits
- Strong analytical and organizational skills.
- Excellent verbal and written communication skills.
- Must be able to work independently.
- Strong project management skills.
Education: Bachelor’s Degree in Accounting and/or Finance from an accredited College or University is preferred Experience: Minimum of five (5) years’ experience in accounting position
Substitutions: Appropriate substitutions may be made for an equivalent combination of education, training and experience. (2) years' experience = 1 year education and training.
