Billing Representative

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For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.

To learn more about the "Montefiore Difference" - who we are at Montefiore and all that we have to offer our associates, please click here.

Over the past fifty years, Montefiore's Division of Services for Addiction has helped thousands of people enter recovery and re-join their families and communities. Through recovery, individuals are empowered to help find meaning in their lives and integrate back into their communities.

The Billing Representative 4C will participate in the patient fee billing and collection system or the Division of Substance Abuse (DoSA) OTP, outpatient addiction, and primary medical care clinics. The Billing Representative will collaborate with clinical staff to obtain all necessary documentation required for billing to Patient, Medicaid, or other insurance and will enter financial data in the program's billing database and will work to resolve any denied payments.

Responsibilities:
* Collaborate with clinical staff to obtain all necessary documentation required for billing to patient, Medicaid, or other insurances. Enter financial data, including Medicaid numbers, gender, date of birth and other insurance codes into program's billing database
* Set all weekly rates using a sliding fee scale and documentation provided by the patient. With appropriate documentation, review requests from the clinic for adjustment of patient weekly fees and balances
* Review financial assessment performed by clinical staff of all patients upon admission or change in patient's financial circumstances to determine method of payment for services
* Identify and contact clinical staff regarding patients who are delinquent in paying for program services
* Review, process, and monitor billing for claims service claims including OTP, HIV Counseling, Case Management and Testing, HIV Primary Care, Chemical Dependency and patient transportation
* Ensure billing is scheduled and collections are reviewed on a continuous basis. Maintain contact with program's billing services, insurance companies, Medicaid, and NYC dept. of finance
* Compute and submit revenue deposits posted on a general ledger and reported on grants
* Bill private insurance carriers for patients whose care is reimbursable through these companies. Maintain records of patients with private insurance
* Prepare and submit claims, re-billing denied claims and back billing claims to Medicaid and other accepted insurances. Maintain database reconciliation. Review denials and enter corrections into billing database
* Develop reports to track weekly scheduled visits
* Perform other duties as assigned

Qualifications:
* Must have high level of proficiency with MS Office (Word, Excel), medical databases (EPIC, office ally, IMA), completing claim forms submitting requested information to vendors
* Must type 25 Words per minute
* High School Diploma / GED required, medical billing and coding preferred
* 3 + years of working experience as a Medical Coder (CPC strongly preferred) with insurance verification and authorization is a must
* Must have strong knowledge of CPT and ICD-10 billing codes and knowledge of Medicaid and commercial insurance billing
* Must be detail oriented, be able to meet strict deadlines, and have strong customer service skills to be able to interact with patients and industry professionals

The hours are 9:00am - 5:00pm Monday through Friday. Must be able to work alterative locations and shifts due to operational needs

This is a 100% Grant funded position