Medicaid Billing Clerk

It's fun to work in a company where people truly BELIEVE in what they're doing!

We're committed to bringing passion and customer focus to the business.

Public Partnerships LLC supports individuals with disabilities or chronic illnesses and aging adults, to remain in their homes and communities and “self” direct their own long-term home care. Our role as the nation’s largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and services within their state-approved personalized budget. We are appointed by states and managed healthcare organizations to better serve more of their residents and members requiring long-term care and ensure the efficient use of taxpayer funded services.

Our culture attracts and rewards people who are results-oriented and strive to exceed customer expectations. We desire motivated candidates who are excited to join our fast-paced, entrepreneurial environment, and who want to make a difference in helping transform the lives of the consumers we serve. (learn more at www.pplfirst.com).

*Candidates must reside in NY State to be considered. *

The Medicaid Billing Clerk serves as a trusted resource for managing the revenue cycle operations that are critical to ensuring strong organizational cash flow, low denial rates, efficient denial root cause analysis, and mitigation of bad debt outcomes. This role optimizes various external and internal platforms to enhance bottom-line results and directly supports the Revenue Cycle Management Team in maintaining payer-specific revenue cycle success.

Key Responsibilities

Billing Operations & Claims Management

• Prepare and manage weekly billing activities and invoice submissions.
• Prepare and re-submit corrected claims or invoices as needed.
• Bill payers by inputting billing information into databases.
• Appeal denied claims utilizing clearinghouse or payer portal functionality.

Reconciliation, Reporting & Revenue Accuracy

• Reconcile billing activities between clearinghouse and host systems.
• Reconcile payments and perform denial research using database queries and spreadsheet analysis.
• Verify and maintain accurate receivable balances across multiple information systems.
• Prepare reports based on Medicaid billing data and revenue.
• Adjust patient bills by reviewing remittance advice and consulting with management.
• Resolve billing discrepancies by conducting research and correcting errors.

Collections, Denials & Payment Resolution

• Perform minimal business-to-business collection activity to maintain low and current receivable balances.
• Follow up on delinquent payer remittances and payments.
• Escalate emerging denial trends and determine root cause analyses.

Required Skills

• Knowledge of medical billing terminology.
• Proficiency with medical billing and clearinghouse systems.
• Strong attention to detail and organizational skills.
• Excellent verbal and written communication skills.
• Proficient knowledge of Microsoft Excel.
• High level of data entry accuracy and speed.

Qualifications

Education: Related Bachelor’s degree preferred; can be substituted with 1+ years of related experience.

Experience:

• Minimum of 3 years of experience in medical billing.
• Experience in self-directed work environments a plus.

Certification:

• Relevant medical billing or coding certification preferred.

Compensation: $23.56 -$25.77 / hourly

The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities, or skills of personnel so classified

PPL is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PPL, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PPL will not tolerate discrimination or harassment based on any of these characteristics.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!