Billing Professional - Sun River Health : Job Details

Sun River Health provides the highest quality of comprehensive primary, preventative and behavioral health services to all who see it, regardless of insurance status and ability to pay, especially for the underserved and vulnerable. Sun River Health is a Federally Qualified, Non-Profit Health Center serving communities in Suffolk, Rockland, Orange, Dutchess, Ulster, Sullivan, Columbia and Westchester County. Solutions 4 Community Health, (S4CH) is a wholly owned entity of Sun River Health. Solutions 4 Community Health (S4CH) provides management solutions for health care safety net providers to improve their care delivery and outcomes, sustainability and efficiency and is currently seeking a full-time remote CPC Billing Professional.

The Billing Professional will report to the Supervisor of Revenue Cycle and work closely with the Manager of Revenue Cycle, the Director of Revenue Cycle and the VP of Information and Practice Management.

The Billing Professional will be responsible for timely follow-up and review of Accounts Receivable. Responsibilities include:

* Ensuring unpaid claims are reviewed and appropriate action is taken.

* Denials are worked and appealed as appropriate.

* Appropriate appeals are written, sent to the payer and followed up on in a timely manner.

* Appropriate insurance adjustments are applied as needed.

The Billing Professional will work with the Finance Department to reconcile the payment and subsequent cash reports. Additionally, it will be their responsibility to communicate to their Supervisor any problems or issues as they occur. They will maintain a current knowledge of payer guidelines, fee schedules, contracts, quality incentives, and system knowledge including ECW, Cognos and Claim Remedi. Other responsibilities include collaborating with other billing staff and communicating with our network of community health centers. As well as professional demeanor, adherence to all Sun River Health policies and procedures is required.

Requirements:

* Minimum of one to two years of experience in billing or revenue cycle management in either a physician practice or other similar setting.

* Associates Degree or equivalent experience is preferred. High School Diploma/GED required.

* Certification in Coding (CPC) is required through AAPC

* Experience with New York State Medicaid (EMEDNY, Epaces) and third party (commercial carriers) insurance follow up preferred

* Knowledge of New York State Department of Health programs or federally qualified health center operations considered advantageous.

* Experience working in a diverse employment setting and working collaboratively with other employees is advantageous.

Sun River Health is a network of over 40 Federally Qualified Health Centers (FQHCs) providing primary, dental, pediatric, OB-GYN, and behavioral health care to over 245,000 patients annually. With a dedicated staff of 2,000 doctors, nurses, and health care professionals, we pride ourselves on delivering high-quality, affordable care to those who need it most. Sun River Health started in 1975 when four African American mothers spearheaded efforts to open our first health center in Peekskill, New York to deliver accessible, high-quality, affordable services to patients in need no matter their race, religion, income, or insurance status. Today, after 45 years of service, Sun River Health is still delivering on that promise to communities across the Hudson Valley, New York City, and Long Island.

Job Type: full-time

Salary: $21.00 - $23.00 per hour