Billing Specialist

Job not on LinkedIn

November 8

🗽 New York – Remote

Although this job is listed in New York, this company may be open to hiring remote in other states.

💵 $58k - $62.5k / year

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

📊 Billing Specialist

🦅 H1B Visa Sponsor

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Mae

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Healthcare Insurance • Wellness • Education

Mae is a company dedicated to providing pregnancy and postpartum support tailored specifically to Black women. It offers weekly health tracking, personalized lifestyle and care tips, and access to culturally competent experts such as doulas and lactation consultants. Mae emphasizes the importance of cultural competency in healthcare, ensuring that the unique experiences and cultural identities of Black women are respected. The platform provides a range of resources, including group classes and expert education, to empower women through self-awareness and advocacy. Mae's services are designed to support a safe and informed pregnancy journey.

2 - 10 employees

⚕️ Healthcare Insurance

🧘 Wellness

📚 Education

💰 $1.3M Seed Round on 2021-09

📋 Description

• Ensure claims are submitted promptly and accurately to the appropriate payer • Liaise with Mae Health’s program managers and health plan Electronic Data Interchange (EDI) / billing points-of-contact to identify and troubleshoot issues with claims submission and/or payment • Review claims prior to submission for coding accuracy, appropriate rate assignments, and completeness to ensure high standards of “clean claim” submissions • Timely reviewing, processing, and submission of claims, tracking claims throughout their life cycle from pre-submission review to final provider payout • Monitors claim statuses and follows up on all claims not processed within Mae’s Service Level Agreements (SLAs) for timely claims processing • Resolves claim errors and/or discrepancies and expediently communicates any issues to plan EDI point-of-contact and relevant Mae personnel • Resolves disputed claims by consulting with appropriate internal and external stakeholders • Monitors and tracks claim payments in Candid and flag for provider direct-payment accordingly • Monitor and process payments Mae’s database for claims in queue for Priority Payout based on SLA requirements for timely payment • Preparing reports for Mae’s Executive Leadership Team on claims trends, performance against SLAs, and identifying issues or concerns with claims adjudication that require further escalation • Provide direct provider support for billing-specific inquiries received via Mae’s customer support database • Providing timely and accurate responses to health plan’s EDI points-of-contact for ongoing claims adjudication issues • Meticulous record-keeping of claim submissions, status, and pertinent notes to keep internal stakeholders informed • Stays up-to-date on information required for claims submission and remittance, and associated contracted rates, including oversight and maintenance of Mae’s Billing Codebook in collaboration with program managers and VP of Partner Success

🎯 Requirements

• Strong understanding of healthcare billing, coding, and claims-management processes • Experience with revenue cycle management platforms required; experience with Candid Health strongly preferred • Dynamic, solution-oriented, and collaborative individuals • Strong organizational skills and ability to manage multiple workstreams in a fast-paced environment • Exceptional attention to detail and accuracy in managing member and financial data • Strong analytical skills and ability to recognize trends and identify inefficiencies • Strong written and verbal communication and interpersonal skills for Mae executive leadership team, service providers, and payer interactions • 3 to 5 or more years of previous Medicaid billing experience

🏖️ Benefits

• Flexible U.S. work location