About this opportunity
Care Compass Network lists this SCN Billing Specialist (HYBRID) opportunity in binghamton, New York. Review the employer’s description below for duties, qualifications and application requirements.
Job description
SCN Billing Specialist For Care Compass CollaborativeReporting to the Manager of Revenue Integrity & Compliance, the SCN Billing Specialist for Care Compass Collaborative is responsible for managing the billing and reimbursement processes for services delivered under the New York Health Equity Reform (NYHER) 1115 Waiver. This includes ensuring accurate and timely submission of claims for Health-Related Social Needs (HRSN) services such as housing, nutrition, transportation, and care management. The Billing Specialist will work closely with the Revenue Cycle Team to ensure compliance with state and federal billing guidelines.The responsibilities of the SCN Billing Specialist will include the following:Essential Functions:Prepare and submit claims for HRSN services in accordance with NYSDOH billing protocols and SCN Operations ManualVerify member eligibility and service authorization using Medicaid data systems and SCN IT platformsTrack and reconcile payments, denials, and resubmissions; follow up on unpaid or underpaid claimsMaintain accurate billing records and documentation for audit readinessCollaborate with Social Care Navigators, care managers, and provider agencies to resolve billing discrepanciesStay current on NYHER 1115 Waiver updates, billing codes, and reimbursement policiesParticipate in training sessions and stakeholder meetings to align billing practices with evolving SCN requirementsNon-Essential Functions:May assume additional responsibilities, as requested.Minimum Requirements:High School Diploma and 2 years' experience required or Associate's degree in Health Administration, Accounting, or related field, preferredMinimum 2 years of experience in Medicaid billing, preferably in a community-based or managed care settingProficiency in billing software, Medicaid portals, and electronic health record (EHR) systemsStrong attention to detail, organizational skills, and ability to manage multiple prioritiesExcellent communication and critical thinking skillsWorking knowledge of Microsoft Office 365License/Certification:Minimum Required: N/APreferred Skills:Knowledge of NYS Medicaid Managed Care billing requirementsFamiliarity with 1115 Waiver programs, HRSN services, and SCN workflows is highly desirableExperience with Unite Us or similar referral platforms used in SCN operations, such as MillinProUnderstanding of social determinants of health and community-based service deliveryKnowledge of NYS OMH, OASAS, and OPWDD or other rate-based billing is a plusWork Environment:Care Compass Network utilizes a hybrid work model where employees are able to work remotely from a home office or from the CCN office, a non-clinical professional office setting. There may be some travel required for partner and/or network meetings.
Worksite address
binghamton, NY, 13901, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.