Provider Service Specialist

Job Description

Summary: This is a full-time non-supervisory position which is an entry level billing position responsible for duties in the Care Services department. This position’s area of responsibility consists of performing a variety of tasks which include but are not limited to admin support for Provider Relations and DOEA Billing, as well as special provider relations and billing projects assigned by management. These duties require the ability to perform a variety of organizational and accounting tasks by applying the accepted and/or approved policies and procedures of the department.

Qualifications/Requirements:

Minimum qualifications include at least (1) year of experience in fiscal, accounting, or billing fields of work. The candidate must successfully complete all pre-hire screenings. The candidate must also pass level II background screening and re-screen every five years.

  • Must have math, reading and writing abilities
  • At least one year experience with DOEA funded programs preferred
  • Must be able to understand and follow complex oral and written instructions and technical terminology
  • Must have proficiency and accuracy in Microsoft Excel, Microsoft Word, 10-key calculator and general ledger software
  • Must have working knowledge of financial concepts, practices and procedures, with the ability to apply according to the policy and procedures of the accounting department and/or organization
  • Must be able prioritize multiple tasks/projects and rely on judgment and experience to plan and accomplish goals efficiently and accurately
  • Must be able to communicate on multiple levels using a variety of methods effectively with customers and clients
  • Must be able to maintain confidentiality of accounting information
  • Must be detailed oriented and possess analytical skills
  • Must be able to interact efficiently with management team and vendors

Essential Functions:

  • Job requires employee to assist with the process of reconciling monthly vendor billing
  • Must document and bill CA for all client specific work on provider services and billing
  • Job requires employee to assist with entering all billing and Data Entry into systems (CIRTS, ServTracker, Medicaid, etc)
  • Job requires employee to post insurance payments in AR systems
  • Frequently communicates with field staff, Case Managers, office personnel and others throughout the organization and community.
  • Assist with annual vendor re-credentialing process
  • Assist with the coordination of authorized services and Case Aide Billing
  • May conduct eligibility checks for all new referrals and once a month for existing clients
  • Job requires employee to pull insurance remittances from the portals
  • Job requires employee to pull EDI files for monthly billing
  • Job requires employee to prepare bi weekly invoices for RELIEF program

Working Conditions/Physical Requirements:

  • Business hours are Monday through Friday, 8:30 a.m.-5:00 p.m. Due to circumstances that may arise, the job may require more than forty hours.
  • Must be able to lift a minimum of 25 pounds with minimal effort following required safety guidelines.
  • Must be able to work in an office environment.
  • Must be able to bend or stoop frequently at many intervals during the day.
  • Must be able to twist and rotate 180 degrees during each day.
  • Must be able to sit at and work on a computer for at least 8 hours a day.
  • Must be able to handle stress when confronted with emergency situations with which speed is essential.

Anyone interested is encouraged to submit their resume for review.

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