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Accounts Receivable Specialist

Type: Full-Time (37.5 hours/week)

Job Summary

To promote the mission of PATH to help individuals achieve a more independent and fulfilling life by being an effective team member. Confirm and update client eligibility.  Prepare and submit 837P electronic billing files and CMS1500 paper claim forms.  Download and review response files to the 837 billing files. Post electronic and manual payment files as received.  Perform all billing and cash posting tasks in a timely manner in order to ensure maximum revenue and facilitate cash flow.  Provide the Accounts Receivable Supervisor and Chief Information Officer with the necessary information to resolve all billing and funding discrepancies.

Specific Duties

  1. Rebill services to Secondary Payers as needed, including preparing and submitting HCFA1500 paper forms and all relevant documentation.
  2. Review the 277 workbooks and Rejections workbooks for all Guarantors on a weekly basis.
  3. Correct and resubmit services in the 277 and Rejection workbooks as needed.
  4. Write-off services in the 277 and Rejection workbooks as needed.
  5. File TPL Discrepancies to CBH as needed based on the 277 Rejections for CBH.
  6. Generate and submit to DBH (Philadelphia County) all electronic requests for MHX Clearance for new Clients each week.
  7. Download and review the response file to the MHX Clearance submission.
  8. Identify Clients that are ineligible for MHX Clearance for reasons such as no Social Security Number, and flag in Avatar.
  9. Download the MHX Feedback Report on a weekly basis.
  10. Identify and flag in Avatar Clients that have been newly approved for MHX Clearance for PATH on the MHX Feedback report.
  11. Prepare the monthly import file for CRR services and upload into Avatar.
  12. Generate and submit billing files to DBH for Outpatient, CRR, BCM, and Administrative Case Management services each month.
  13. Download and review the response files for the DBH billing including the ta1, 999, and 277 files within two (2) business days of the submission of the 837 files.
  14. Rename all 277 files to include Client ID, Client Name, and Date of Service.
  15. Enter 277 rejections into the DBH 277 workbook including the reason code(s) for rejection.
  16. Review, correct, update, and resubmit services as needed on the monthly Open Services Reports for all Guarantors.
  17. Review, confirm, sign, and submit DHS invoices monthly.
  18. Enter DHS invoice data into DHS’s P-Drive monthly.
  19. Review and resolve discrepancies on the Credit Balance report monthly.
  20. Provide back-up in assigned tasks for the Accounts Receivable Manager.
  21. Assist in the training and on-going support of new Accounts Receivable staff.

Qualifications

Associate’s Degree. Three to Five years’ experience in Health Care Billing functions, preferably in a Behavioral Health and/or non-profit environment. Ability to run reports necessary to correct and update billing and funding source data. Ability to work with numbers and function with minimal supervision.  Experience and knowledge of Primary and Secondary insurance billing including the input of data, generation of electronic 837 billing files, and electronic and manual cash application of cash received from billings.  Possess the skills needed to interact with outside parties to collect the necessary information for the successful submission of claims.

Location

Systems and Evaluations, Northeast Philadelphia, PA

Schedule

37.5 Hours per week

Salary

$33,462.00 - $34,466.00

 

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