Job Description:

Celebrating 50 years of excellence,NewYorkPsychotherapy and Counseling Center (NYPCC) has been atthe forefront of mental healthand wellness;assisting children, families, and individuals with behavioral and emotional challengesat our five locations throughout thecity.NYPCC is the leading pioneer of community mental health services, serving over 15,000 clients per month. We run and operate the largest clinic in the State of New York andpride ourselves on innovationand "caring for the community"by providingin-person and telehealth servicesfor our clients, whileoffering an unsurpassable and competitive compensation structure and benefits package toour team of dedicated employees.NYPCC is certified by Mental Health America as a Platinum Bell Seal organization, the highest certification possible. NYPCC is proud of our ongoing commitment to employee mental health and well-being.Why Work at NYPCC:We Pay Down Your Student Loans!Medical, Dental, and Vision Insurance is Paid for by NYPCC 100%Paid Time Off and Company Paid Holidays403B Retirement Plan with Match!Professional Development through NYPCC AcademyAmazing Workplace CultureJob DescriptionThe Senior Revenue Cycle Specialist's responsibilities include identifying patient reimbursement issues, ensuring that claims, denials, and appeals are efficiently processed, and resolving billing-related issues.Responsibilities:Manage the billing office activities including, but not limited to, account management, insurance providers' practices and policies, collections, and billing.Manage the billing system to ensure that accurate information is entered.Conduct audits to verify process.Review daily ineligible reports, confirm information with insurance plans.Work with the Medicaid Entitlement Specialists to address client eligibility issues.Review Billing Automation daily reports to research and confirm changes in insurance eligibility.Recode client billing record appropriately and resubmit claims as needed.Monitor clearinghouse claim submissions looking for rejections and correcting problems.Review and follow up on insurance carrier denials and underpaid claims according to contracted fee schedules.Review EMR billing records for denied claims to ensure correct information, such as patient ID, and active insurance. If necessary, correct billing information and resubmit claims.Gather supporting documentation and appeal inappropriate denials by insurance carrier in a timely fashion.File complaints with the state Office of Mental Health (OMH) and Department Of Health (DOH), regarding Medicaid Managed Care Organizations claim denials and not following OMH and DOH regulations and guidance.Confirm validity of overpayment refund requests from insurance carriers, appeal when form leadership of issues and possible trends observed when reviewing denials, so that appropriate actions can be taken.Identify coordination of benefits for patients with secondary and tertiary insurances.Answer questions from patients and third-party payers regarding accounts.Perform other duties as requested by Supervisor.QualificationsBachelor's Degree and at least 2 years of healthcare revenue cycle Lieu of a degree, at least 4 years of healthcare revenue cycle experience.Bilingual EnglishSpanish highly preferred, but not required.Working knowledge of Medicare, NY Medicaid Outpatient reimbursement methodologies and third-party reimbursement methodology and drivers.Desired - Knowledge of NYS Office of Mental Health and Office of Addiction Services and Supports regulations and billing guidance.Knowledge of insurance guidelines and payor policies.Knowledge of medical insurance terminology and definitions such as: deductible, out of pocket, authorization, referral, copayment, Tax ID, NPI, etc.Familiarity with CPT and ICD-10 coding.Proficiency in MS Office, especially Excel.Effective communication and time management skills.Ability to work in a team environment and handle conflict professionally.Problem solving skills to research and resolve insurance discrepancies, denials, and appeals.Maintain patient confidentiality as per HIPAA guidelines.Ability to multi-task.Additional InformationSalary: $60,000 - $75,000 per yearCompensation commensurate with experience and qualifications.