The Claims Biller oversees collections and manages payments for home care invoices and client services. Their work includes updating client data, developing payment plans, ensuring invoices are paid by the contracts, and ensuring that home care contracts and private pay clients are billed timely and accurately. The individual in this position will be responsible for a variety of tasks requiring data analysis, in-depth evaluation, and sound judgment. Daily duties will include maintaining A/R payments/billing software, appealing denied claims, and recording late payments.
Responsibilities
- Monitor and ensure payments are being made in accordance with the terms of the contract.
- Ensure the billing information is accurate and up to date.
- Prepare bills and invoices, and document amounts due for home care services.
- Collect and review referrals and pre-authorizations from the intake department.
- Monitor and record late payments.
- Follow up on missed payments and resolve financial discrepancies.
- Examine home care and contract claims for accuracy and request any missing information.
- Investigate, appeal, and resolve denied claims.
- Help clients develop patient payment plans for surplus monthly charges.
- Maintain billing software by updating rate change, cash spreadsheets, and current collection reports.
- Correct any billing issues and make any necessary adjustments, while communicating this change with the contract and filling appeals where appropriate.
Qualifications
- Associate’s degree in business, health care administration, accounting, or a relevant field.
- A minimum of 2 years of experience as a claims or medical biller or similar role.
- Experience in billing for managed care organizations (MCO) and NYC Human Resources Administration (HRA) is preferred.
- Excellent organizational skills and attention to detail.
- Knowledge of EMEDNY, ClearingHouse, and other electronic billing portals.
- Prior home care experience/billing or HHA exchange software.
- Excellent written and verbal communication skills.
- Attention to detail and problem-solving skills.
Location: SCS currently has a hybrid work model that allows for two days remote per week and three days in the office.
Classification: Non-Exempt
Reports to: Director of Revenue Cycle Management
Work Environment: SCS currently has a hybrid work model with three days in the office and two days remote.
Salary: Commensurate with experience; range: $60,000 – $65,000
Benefits Package
- Comprehensive medical, dental, and vision insurance
- 403(b) retirement plan with employer contribution
- Flexible spending account and transit program
- Employee Assistance Program
- 20 days of paid vacation per year
- 12 paid holidays
- 12 paid sick days per year
- 5 personal/floating days
- Life insurance
- Long-term disability
- Dynamic and safe work environment
How to Apply
If you would like to join our team, please email a cover letter and resume to billingposition@scsny.org. Please indicate “Claims Biller” in the email subject line.
All positions at Sunnyside Community Services are filled without regard to race/color, religion/creed, national origin, age, sex/gender, sexual orientation, gender identity or expression, disability, pregnancy-related condition or lactation, military/veteran status, marital status, familial status, caregiver status, sexual or reproductive health decisions, height, weight, status as a victim of domestic violence/stalking/ sex offenses, predisposing genetic characteristic, immigration or citizenship status, prior arrest or conviction record, credit history, salary history, unemployment status, pre-employment marijuana testing, union affiliation/activity, or for reporting or opposing discrimination on these bases or for reporting or opposing violations of workplace health and safety, pay equity or practices, or for participating in any internal or any legally protected status listed in the New York City Human Rights Law (NYCHRL). All are encouraged to apply.
Sunnyside Community Services strives to address, explore, and educate all our stakeholders about the diversity of human experience and to advance and integrate racial equity and social justice into all organizational policies and programs. We believe that everyone, regardless of who they are or what they do for the organization, should feel equally involved and supported. Sunnyside Community Services represents a commitment to considering the whole person and how systemic barriers and access to opportunities can affect their well-being.
Equal Opportunity/Affirmative Action Employer