Medical Billing and Collections Specialist

The Bridge offers supportive housing and behavioral health services to vulnerable New Yorkers facing behavioral health and substance use challenges. We provide individuals with the tools they need to pursue their dreams and live meaningful lives. The Bridge envisions a world where adults experiencing serious mental illness can live and thrive within their communities. As a recognized leader in developing and operating supportive housing and community-based programs, The Bridge has 70 years of experience helping New Yorkers with mental illness, including those affected by homelessness, incarceration, and institutionalization.

The Medical Billing and Collections Specialist is responsible for ensuring accurate, timely, and compliant billing and collections across a comprehensive range of services. This role prepares and submits electronic claims, monitors claim status, researches and resolves rejections and denials, documents account activity, and posts payments and adjustments. The Specialist works with Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers to ensure proper reimbursement while maintaining compliance with applicable billing and regulatory requirements.

• Prepare, review, and transmit claims using billing software claim processing.
• Responsible for correcting, completing, and processing claims for all payer codes.
• Collaborate with the programs to ensure accurate billing and resolve discrepancies.
• Assist in reconciling billing audit-related information.
• Generate and review all of the billing service reports in the EHR and billing software.
• Follow up with programs on eligibility issues.
• Responsible for charge and payment entry within the EHR.
• Coordinate and clarify with providers about information that seems incomplete or is lacking for proper account/claim adjudication.
• Responsible for correcting, completing, and processing claims for all payers.
• Perform follow-up with Medicare, Medicaid, Managed Care Plans, and Commercial insurance companies on unpaid insurance accounts identified through aging reports.
• Process appeals online or via paper submission.
• Attend provider and program meetings as needed.
• Communicate with billing and credentialing specialists to identify and resolve issues.
• Process billing calls and questions from third-party carriers.
• Answer/respond to correspondence related to payment recovery and audit accounts.
• Identify trends and carrier issues relating to billing and reimbursements.
• Perform other duties as assigned.

• Associate’s degree in healthcare services, health information management, or a related field from an accredited college; certificate from a billing technical school;
  Certified Biller and Certified Professional Coder a plus.
• 3–5 years of healthcare billing experience, with knowledge of Medicaid, Managed Care, and Medicare billing and payment procedures.
• Knowledge of OMH and OASAS regulations and procedures.
• Knowledge of NYS, CMS, and Managed Care billing and payment regulations.
• Interpersonal skills required for effective communication and troubleshooting.
• Ability to research and analyze data.
• Ability to work independently.

The Bridge Inc. is an affirmative action / equal opportunity employer