Billing Professional

Sun River Health provides the highest quality of comprehensive primary, preventative and behavioral health services to all who see it, regardless of insurance status and ability to pay, especially for the underserved and vulnerable. Sun River Health is a Federally Qualified, Non-Profit Health Center serving communities in Suffolk, Rockland, Orange, Dutchess, Ulster, Sullivan, Columbia, Westchester Counties and New York City.

Solutions 4 Community Health, (S4CH) is a wholly owned entity of Sun River Health. Solutions 4 Community Health (S4CH) provides management solutions for health care safety net providers to improve their care delivery and outcomes, sustainability and efficiency and is currently seeking a full-time remote CPC Billing Professional.

The Billing Professional will report to the Supervisor of Revenue Cycle and work closely with the Manager of Revenue Cycle, the Director of Revenue Cycle and the VP of Information and Practice Management.

The Billing Professional will be responsible for timely follow-up and review of Accounts Receivable. Responsibilities include:

• Ensuring unpaid claims are reviewed and appropriate action is taken.

• Denials are worked and appealed as appropriate.

• Appropriate appeals are written, sent to the payer and followed up on in a timely manner.

• Appropriate insurance adjustments are applied as needed

The Billing Professional will work with the Finance Department to reconcile the payment and subsequent cash reports. Additionally, it will be their responsibility to communicate to their Supervisor any problems or issues as they occur.

They will maintain a current knowledge of payer guidelines, fee schedules, contracts, quality incentives, and system knowledge including ECW, Cognos and Claim Remedi. Other responsibilities include working well with other billing staff and communicating with our network of community health centers. As well as professional demeanor, adherence to all Sun River Health policies and procedures is required.

A qualified candidate will have a minimum of one to two years of experience in billing or revenue cycle management in either a physician practice or other similar setting.

An Associates Degree or equivalent experience is preferred. High School Diploma/GED required.

Certification in Coding (CPC) is required.

Experience with New York State Medicaid (EMEDNY, Epaces) and third party (commercial carriers) insurance follow up preferred

Possessing knowledge of New York State Department of Health programs or federally qualified health center operations considered advantageous.

In addition, demonstrated experience working in a diverse employment setting and working collaboratively with other employees is advantageous.

Job Type: Full-time

Pay: $19.50 - $25.50 per hour

Expected hours: 35 per week