Billing Specialist - I

Overview

Partners For Quality, Inc. DEPARTMENT : Fiscal POSITION : Billing Specialist I STATUS : Full Time; 37.5 hours/week SCHEDULE / HOURS : Monday through Friday; 8:00AM - 4:00PM LOCATION : Robinson Township Partners For Quality Inc. (PFQ) is a private, non-profit organization based in Robinson Township. Partners For Quality provides administrative management to five subsidiary organizations that support local individuals with intellectual & developmental disabilities and behavioral health challenges.

PFQ’s management services include Fiscal (including payroll), HR, IT and Communications thus allowing subsidiaries to focus on their day-to-day priorities.

Responsibilities

Reports to the Revenue Cycle Director and/or Manager. Responsible for ensuring the accurate and timely processing of claims for our Mental & Behavioral Health and Intellectual Disabilities/Autism serving agencies. Monitor and respond to unpaid claims, denials and appeals to minimize the days outstanding of accounts receivable.

This position supports the mission, vision, and operational needs of Partners For Quality (PFQ) and its family of agencies. Employees will be required to collaborate with, provide services to, or support initiatives across all PFQ agencies, as business needs dictate. All employees are expected to demonstrate and uphold PFQ's CHOICES Guiding Principles in their daily work, interactions, and decision-making: Care : Demonstrate kindness, empathy, and integrity.

Holistic : Consider the whole person and broader impact of actions. Opportunity : Seek creative solutions and possibilities for growth. Inclusion : Foster a respectful and welcoming environment. Collaborate : Work cooperatively with colleagues, individuals served, families, and community partners. Empower : Encourage growth, learning, and informed decision-making.

Support : Promote a person-centered approach that helps others achieve their goals. Demonstration of the CHOICES Guiding Principles is an essential function of all positions and will be considered as part of performance expectations and evaluations. Billing & Claims Processing Prepare and submit invoices or claims to Medicaid, Medicare, private insurance, and other funding sources.

Verify client eligibility for services, when applicable. Track and follow up on unpaid claims, denials, and appeals. Financial & Administrative Support Maintain accurate records of billing transactions, payments, and outstanding balances. Assist with reconciliation of accounts and resolve billing discrepancies. Work with finance and program staff to ensure proper documentation for services rendered.

Respond to inquiries from clients, insurance companies, and internal staff regarding billing issues. Prepare and maintain additional reports as requested. Perform other related duties as assigned. Compliance & Documentation Ensure compliance with federal, state, and agency specific billing regulations. Keep up to date with changes in healthcare billing codes and payer policies.

Maintain confidentiality of client financial and personal information in accordance with HIPAA. Understanding and compliance with all Partner For Quality (PFQ) Financial Policies and Procedures and PFQ Corporate Personnel Policies and Procedures. CASH INCENTIVES Employees have the opportunity to earn additional money through our employee referral program BENEFITS Full Time employees enjoy a comprehensive benefits package: Health, Dental and Vision Insurances $1,200 cash payout option in lieu of Health Insurance coverage Healthcare Flexible Spending Account Dependent Care Flexible Spending Account 16 to 26 Paid Days Off / year Wellness Days (2 per year) Sick Time 8 Paid Holidays Short Term Disability Long Term Disability Life Insurance Optional 401(k) with Employer match WORK PERKS Paid orientation and training Free parking (select locations) Employee Activities, Rewards and Recognition Programs Comprehensive Employee Assistance Program APPLY TO THIS POSITION Interested applicants can choose to apply in any of the following ways: Complete an employment application online Email resumes:Careers@PFQ.

org Partners For Quality and its family of agencies are an equal opportunity employer EOE Qualifications High School Diploma or GED with a minimum 3 years related experience. Associate or Bachelor’s degree Preferred Required Prior experience in a human services agency in medical or social services billing, Medicaid/Medicare claims processing, or financial administration.

Proficient in all Microsoft EXCEL & WORD applications Knowledge of medical billing software and/or electronic health records (EHR) systems. Strong attention to detail and problem-solving skills Ability to work independently and as part of a team in a fast-paced environment. Valid Driver’s License Act 33, 34 and FBI Clearances Minimum Compensation USD $21.

50/Hr. Maximum Compensation USD $24.00/Hr. Reports to the Revenue Cycle Director and/or Manager. Responsible for ensuring the accurate and timely processing of claims for our Mental & Behavioral Health and Intellectual Disabilities/Autism serving agencies. Monitor and respond to unpaid claims, denials and appeals to minimize the days outstanding of accounts receivable.

This position supports the mission, vision, and operational needs of Partners For Quality (PFQ) and its family of agencies. Employees will be required to collaborate with, provide services to, or support initiatives across all PFQ agencies, as business needs dictate. All employees are expected to demonstrate and uphold PFQ's CHOICES Guiding Principles in their daily work, interactions, and decision-making: Care : Demonstrate kindness, empathy, and integrity.

Holistic : Consider the whole person and broader impact of actions. Opportunity : Seek creative solutions and possibilities for growth. Inclusion : Foster a respectful and welcoming environment. Collaborate : Work cooperatively with colleagues, individuals served, families, and community partners. Empower : Encourage growth, learning, and informed decision-making.

Support : Promote a person-centered approach that helps others achieve their goals. Demonstration of the CHOICES Guiding Principles is an essential function of all positions and will be considered as part of performance expectations and evaluations. Billing & Claims Processing Prepare and submit invoices or claims to Medicaid, Medicare, private insurance, and other funding sources.

Verify client eligibility for services, when applicable. Track and follow up on unpaid claims, denials, and appeals. Financial & Administrative Support Maintain accurate records of billing transactions, payments, and outstanding balances. Assist with reconciliation of accounts and resolve billing discrepancies. Work with finance and program staff to ensure proper documentation for services rendered.

Respond to inquiries from clients, insurance companies, and internal staff regarding billing issues. Prepare and maintain additional reports as requested. Perform other related duties as assigned. Compliance & Documentation Ensure compliance with federal, state, and agency specific billing regulations. Keep up to date with changes in healthcare billing codes and payer policies.

Maintain confidentiality of client financial and personal information in accordance with HIPAA. Understanding and compliance with all Partner For Quality (PFQ) Financial Policies and Procedures and PFQ Corporate Personnel Policies and Procedures. CASH INCENTIVES Employees have the opportunity to earn additional money through our employee referral program BENEFITS Full Time employees enjoy a comprehensive benefits package: Health, Dental and Vision Insurances $1,200 cash payout option in lieu of Health Insurance coverage Healthcare Flexible Spending Account Dependent Care Flexible Spending Account 16 to 26 Paid Days Off / year Wellness Days (2 per year) Sick Time 8 Paid Holidays Short Term Disability Long Term Disability Life Insurance Optional 401(k) with Employer match WORK PERKS Paid orientation and training Free parking (select locations) Employee Activities, Rewards and Recognition Programs Comprehensive Employee Assistance Program APPLY TO THIS POSITION Interested applicants can choose to apply in any of the following ways: Complete an employment application online Email resumes:Careers@PFQ.

org Partners For Quality and its family of agencies are an equal opportunity employer EOE High School Diploma or GED with a minimum 3 years related experience. Associate or Bachelor’s degree Preferred Required Prior experience in a human services agency in medical or social services billing, Medicaid/Medicare claims processing, or financial administration.

Proficient in all Microsoft EXCEL & WORD applications Knowledge of medical billing software and/or electronic health records (EHR) systems. Strong attention to detail and problem-solving skills Ability to work independently and as part of a team in a fast-paced environment. Valid Driver’s License Act 33, 34 and FBI Clearances