Philadelphia, PA, USA
Monday, May 3, 2021
THE MISSION OF PROJECT HOME
The mission of the Project HOME community is to empower adults, children, and families to break the cycle of homelessness and poverty, to alleviate the underlying causes of poverty, and to enable all of us to attain our fullest potential as individuals and as members of the broader society. We strive to create a safe and respectful environment where we support each other in our struggles for self-esteem, recovery, and the confidence to move toward self-actualization.
Project HOME achieves its mission through a continuum of services comprised of street outreach, a range of supportive housing, and comprehensive services. We address the root causes of homelessness through neighborhood-based affordable housing, economic development, and environmental enhancement programs, as well as through providing access to employment opportunities; adult and youth education; and health care.
Project HOME is committed to social and political advocacy. An integral part of our work is education about the realities of homelessness and poverty and vigorous advocacy on behalf of and with homeless and low-income persons for more just and humane public policies.
Project HOME is committed to nurturing a spirit of community among persons from all walks of life, all of whom have a role to play in making this a more just and compassionate society.
THE VALUES OF PROJECT HOME
The work of Project HOME is rooted in our strong spiritual conviction of the dignity of each person.
We believe that all persons are entitled to decent, affordable housing and access to quality education, employment, and health care.
We believe in the transformational power of building relationships and community as the ultimate answer to the degradation of homelessness and poverty.
We believe that working to end homelessness and poverty enhances the quality of life for everyone in our community.
We believe that the critical resources entrusted to us to achieve our mission must be managed honorably and professionally.
Job Summary: Responsible for timely and accurate billing claim submission to responsible third-party payers. Responsible for monitoring and development of billing staff. Assures compliance with Medicare, Medicaid, Commercial Insurances, Federal and State Laws impacting Federally Qualified Health Centers (FQHCs). Monitors and creates edits in the electronic billing system to achieve accurate high clean claim ratios.
Essential Duties and Responsibilities
- Oversees the billing functions, including the initiation of goals and procedures, overseeing daily operations, and coordinating efforts to expedite payment of accounts.
- Supervises hourly employees in performance of tasks associated with billing and collection from third party payers. Monitors billing processes of billing staff to assure that billing is correct and timely.
- Reviews and resolves issues related to claim generations, clean claim ratios, rejected, denied billings. Determines the accuracy of charge capture, missing charges, late charges, covered and non-covered charges.
- Ensures appropriate and professional communication with payers and patients.
- Elevates issues with payers and reports improvement as appropriate.
- Serves as a resource to staff by answering questions, assisting with problems, and providing training, as necessary.
- Implements quality and performance improvement measures for the billing function.
- Ensures timely submission and acceptance of claims to all payers.
- Must be capable of performing all tasks required of hourly billing and collection employees, including provider credentialing.
- Uses a wide variety of communication formats to keep staff regularly informed and trained with one to one and team meetings.
- Identifies accounts not selected for billing. Reviews system generated billing, collections other reports to monitor weekly collections, billed and unbilled accounts.
- Communicates issues that are preventing timely and accurate billings to appropriate department Manager for performance improvement process.
- Identifies and collects on underpaid accounts.
- Reviews Claims Edit List to monitor specific issues, as well as recurring issues and resolution.
- Recommends future course of action based on data interpretation and recommends system changes, as appropriate.
- Identifies new payer contracts, ensures proper legal review, and recommends execution based on practice’s focus of serving the homeless and at-risk populations in Philadelphia. Ensures that appropriate workflows, policies, and procedures are in place to comply with contract requirements.
- Responsible for payer enrollment and recertification
- Provide input for the annual Medicare cost report.
- Bachelor's degree in Business or a related field preferred, High School graduate or equivalent required
- Hold current medical billing and coding certification from the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA)
- Minimum of two (2) years of previous supervisory billing experience in a FQHC or similar organization.
- Demonstrated experience collaborating across departments.
- Effective communication skills
- Strong knowledge of Microsoft Office with advanced knowledge of Excel preferred.
- Proven ability to work efficiently, effectively, and proactively in a fast-paced, deadline-oriented, environment.
- Ability to clearly follow processes and procedures, and ability to use sound judgment.
- Sedentary work that primarily involves sitting/standing.
Project HOME is an Equal Opportunity Employer
The mission of the Project HOME community is to empower adults, youth, and families to break the cycle of homelessness and poverty, to alleviate the underlying causes of poverty, and to enable all of us to attain our fullest potential as individuals and as members of the broader society. We strive to create a safe and respectful environment where we support each other in our struggles for self-esteem, recovery, and the confidence to move toward self-actualization. Join us! Project HOME has a long-standing commitment to equal employment opportunity for all staff and applicants for employment. Employment decisions including, but not limited to, hiring selection, performance evaluation, administration of benefits, working conditions, associate programs, transfers, position changes, training, disciplinary action, compensation, and separations are made without regard to race, color, religion (including religious dress and grooming), creed, national origin, nationality, citizenship status, domestic partnership status, ancestry, gender, affectional or sexual orientation, gender identity or expression, marital status, civil union status, family status, age, mental or physical disability (including AIDS or HIV-related status), atypical heredity cellular or blood trait of an individual, genetic information or refusal to submit to a genetic test or make available the results of a genetic test, military status, veteran status, or any other characteristic protected by applicable federal, state, or local laws.