Billing and Contracts Administrative Supervisor

  • New York, NY, US

When applying, indicate "Billing Administrative Supervisor" in the subject line, and submit cover letter and resume to:

Mary Ann Code

Human Resources Department

New Alternatives for Children

37 West 26th Street, 11th Floor

New York, NY 10010

Fax: 212-545-7375

Phone: 212-994-7938

Email: HR@nackidscan.org

PROGRAM DESCRIPTION

New Alternatives for Children, Inc. (NAC) is a child welfare agency in Midtown Manhattan that serves children with medical complexity, significant disabilities or severe emotional or behavioral conditions and their families through a range of clinical programs, healthcare and social services.

NAC has two NYS licensed onsite clinics: An Article 31 Mental Health Treatment Clinic and Article 28 Diagnostic & Treatment Center; and a Mobile Medical Clinic. The Billing and Contracts Administrative Supervisor will have overall responsibility for clinic billing and contracting functions, including day-to-day operations and staff supervision.

"WE ARE AN EQUAL OPPORTUNITY EMPLOYER, COMMITTED TO DIVERSITY"

MAJOR DUTIES & RESPONSIBILITIES:

  • Review new and existing Medicaid Managed Care, Medicare and Commercial insurance contracts and amendments including scope of services, reimbursement and issues that pertain to day-to-day operations.
  • Identify opportunities for improvements in new and existing contracts and address through initial negotiations and annual renegotiations.
  • Expand number of agency contracts with Commercial and other insurance payers.
  • Maintain current credentials on each provider including all information needed for credentialing and contracting, and monitor credentialing processes and timelines of each plan.
  • Supervise clinic billing workflow, including generation and submission of Encounter Forms, medical coding, billing and payment posting.
  • Enforce billing policies and procedures.
  • Develop and implement systems to streamline processes and reduce billing errors.
  • Identify and train all relevant staff in medical coding practices that optimize reimbursement.
  • Manage and oversee service pre-authorization processes required by each plan, including tracking client utilization of pre-authorized service units and timeframes.
  • Ensure timely billing and compliance with payer rules and deadlines.
  • Oversee fee schedule rates for insurance plans to ensure proper remittances.
  • Investigate billing problems, formulate and implement solutions.
  • Work with insurance providers and others to resolve billing issues.
  • Oversee claim resubmission projects as necessary, including preparation of information requests on unpaid or underpaid claims for resubmission to payers.
  • Monitor updates/changes to billing rules, regulations and requirements and inform providers and billing staff.
  • Generate monthly, quarterly and annual billing and remittance reports.
  • Oversee ongoing implementation of Electronic Health Record (EHR) as it pertains to clinic processes and billing.
  • Handle electronic and mail correspondence from payers.
  • Perform other duties as assigned.

QUALIFICATIONS & COMPETENCIES:

  • At least 5 years of experience in billing and contracting operations in clinic/practice setting, including supervision of staff and operations.
  • Thorough knowledge of Medicaid Managed Care, Medicare and Commercial reimbursement practices.
  • Experience in contract review, negotiation and administration.
  • Knowledge of reimbursement systems, regulations and polices pertaining to coding, billing and documentation.

In addition the candidate must demonstrate the following competencies:

  • Strong supervisory skills and ability to maintain excellent working relationships with staff and providers.
  • Must be able to implement and manage billing operations, improve efficiency and maximize reimbursement.
  • Highly detail oriented, ability to multi-task and follow-up.
  • Strong computer skills.

New Alternatives for Children of New York City

Areas of focus:

  • 37 West 26th Street, 7th floor
    New York, NY, US 10010
    See Map

New Alternatives for Children of New York City

Areas of focus:


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