From program assistants to nurses and program directors, our employees make a difference every day. Our talented team provides elders with day health supports in vibrant community-based settings. And as part of The MENTOR Network— a national network of local health and human services providers—ADH employees are part of a growing organization that’s been at the forefront of providing innovative, community-based care for more than 30 years.
Authorization & Billing SpecialistApply Now Job ID 19000D8R
Authorization & Billing Specialist
Primary Location: United States-MA-MABrockton
We are seeking a professional biller with excellent attention to detail and the ability to process a high volume of transactions. Take ownership of the eligibility and authorization process within your assigned programs. Become a member of our multi-faceted Finance team and collaborate with Operations.
MENTOR Adult Day Health, a partner of The MENTOR Network, provides high-quality services to elders, including those with complex medical or rehabilitative needs. We offer vibrant day programs that help them remain in their homes instead of requiring higher levels of care such as nursing homes. Join our team today!
The Authorization & Billing Specialist serves as the liaison between Operations and Finance and is responsible for all revenue recognition for each person served as well as obtaining authorizations and performing routine eligibility checks while clients are in our care.
- Proactively works with the program in order to obtain eligibility and initial authorizations for all new admissions and “Unfunded” persons served
- Utilizes the main billing systems (Avatar & iServe) to capture service entry, admissions, discharges and transfers prior to billing
- Proactively reviews eligibility and submits requests to the SSC in order to update payer information and/or changes
- Manages and proactively obtains all persons served subsequent authorizations (until discharged) and submits to the SSC in order to process
- Reviews Attendance and Meal Counts for accuracy prior to charge entry
- Reconciles weekly and monthly service capture for all payers/clients prior to billing
- Maintains supporting documentation (Attendance, Meal Counts and reconciled Trended Units Report) for service entry
- Actively participates and provides an overview of authorization and eligibility issues in weekly/monthly AR calls. Will also provide information to be used in the quarterly reserve process
- Ensures internal control compliance by adhering to audit requirements within all assigned areas
- Assists with the resolution of any issues that could impact the timing of month-end close
- Assists in the onboarding of new hires by providing required training when necessary
- Performs other related duties and activities as required.
- Responsible for the maintenance of an effective control environment under SOX 404 for the accounting operations he or she oversees. This includes both key and non-key controls and extends to the timely updating and modification of control design where necessary and the oversight of control remediation activities should exceptions be encountered in testing.
What We Ask of You:
- High school diploma or equivalent required
- Post-Secondary degree preferred
- 1+years’ experience in the medical administration field and/or medical billing background required
- Experience with a payer online portal preferred
- Proficiency with Microsoft Word, Excel and Outlook
- Ability to learn quickly, manage and prioritize multiple tasks
- Good written and oral communication skills and the ability to interact with staff of different cultural backgrounds
- Well-developed problem solving skills
- Detail oriented
- Knowledge of EDI 835 formatting helpful but not essential
- Commitment to excellent customer service and support
- Foster culture of continuous improvement
- Data entry skills
- Competitive compensation/benefits package including 401(k), PTO and Holiday Pay
- Dynamic work environment, no day is ever the same as the next
- Advancement opportunities within our nation-wide Network
We have a great work environment and you’ll be surrounded by a strong and supportive team of peers, leaders and colleagues. Adult Day Health is a partner of The MENTOR Network. Founded in 1980, The MENTOR Network is a national network of local human service providers offering quality, community-based services. With approximately 30,000 employees serving 30,000 individuals in 36 states you'll have career opportunities from coast to coast. When you join The MENTOR Network, you’ll make a difference every day and help to provide quality of life enhancing services to individuals across the country.
Come join our team of dedicated and caring professionals. Apply Today!