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Ultimate Care NY, a trusted provider of home health care services in New York, is currently seeking a Billing & Collections Specialist to join our team. In this role, you will be responsible for managing the billing and collections process for Medicare/Medicaid Managed Care claims. You will work closely with our finance and operations teams to ensure accurate and timely submission of claims, follow up on outstanding balances, and resolve any billing discrepancies. As a Billing & Collections Specialist at Ultimate Care NY, you will play a crucial role in maintaining the financial health of our organization and ensuring that our clients receive the care they need.

Responsibilities

• Invoicing: Generate and send invoices to private pay clients for home health services provided.
• Payment Processing: Receive payments from private pay clients through various methods (e.g., checks, credit cards) and record them accurately.
• Aging Reports: Monitor and track accounts receivable, generating aging reports to identify overdue accounts.
• Follow-Up: Contact clients with overdue payments to inquire about outstanding balances and arrange payment plans when necessary.
• Documentation: Maintain detailed records of all billing and payment transactions.
• Collections: Initiate collections procedures, such as sending collection letters or pursuing legal action, for seriously delinquent accounts.

Medicaid Billing and Collections:

• Claim Submission: Prepare and submit Medicaid claims accurately, adhering to the state's billing regulations.
• Documentation: Maintain complete and accurate records, including required documentation for Medicaid reimbursement.
• Remittance Advice: Review Medicaid remittance advice to ensure correct reimbursement and identify any issues.
• Medicaid Compliance: Stay updated on Medicaid billing regulations and requirements to ensure compliance.
• Timely Filing: Monitor and adhere to Medicaid's timely filing requirements to avoid claim rejections.

Skilled Billing (e.g., Medicare Part A or B):

• ICD-10 and CPT Coding: Ensure proper ICD-10 diagnosis and CPT procedure coding for Medicare billing.
• Claims Submission: Prepare and submit Medicare claims to the Centers for Medicare & Medicaid Services (CMS) accurately and in a timely manner.
• ABNs (Advance Beneficiary Notices): Provide ABNs to Medicare beneficiaries when services are likely not to be covered and obtain necessary patient signatures.
• Reimbursement Review: Review Medicare reimbursement schedules and fee-for-service structures.
• Documentation Compliance: Ensure that clinical documentation meets Medicare requirements for skilled services.
• Medicare Compliance: Stay informed about Medicare billing regulations and changes in reimbursement policies.
• Appeals: Manage and respond to Medicare claim denials and file appeals when necessary.

Requirements

• Minimum of 2 years of experience in Medicare billing and collections in a home health care setting
• Strong knowledge of Medicaid regulations and reimbursement processes
• Proficiency in billing software and electronic medical record systems
• Detail-oriented with strong analytical and problem-solving skills
• Excellent communication and interpersonal skills
• Ability to work independently and meet deadlines
• Experience with billing Medicaid Managed Care plans is a plus

Benefits

We offer the Ultimate employee perks (literally)!

• Competitive rate and advancement opportunities
• Healthcare coverage
• 401k Retirement plan & employer match
• Company-sponsored life and accident insurance
• Accident insurance,
• Critical Illness
• Dental
• Hospital Indemnity
• Long Term Disability
• Short Term Disability
• Vision
• Voluntary AD&D
• Voluntary Life
• Generous paid time off, sick time
• Learning and development resources
• An employee of month recognition with structured bonus rewards $$$
• Merit-based employee recognition program with rewards $$$
• Discount programs for restaurants, Broadway shows, movies, shopping, and much more!
• T-Mobile phone plan discounts for employees!

Compensation: $50,000-$70,000

Ultimate Care is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, national origin, disability, protected veteran status, or any other characteristic protected under federal, state, or local law.

Ultimate Care, Inc. does not accept resumes from unsolicited search firms nor recruiters.

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