Resources for Human Development

Resources for Human Development

  • Philadelphia, PA


  • $20.72 per hour

  • Permanent

  • Full-time

Description/Job Summary

The Senior Billing Specialist is responsible for the billing, payment application and resolution of claims submitted for services provided and/or providing support and oversight over such activities for multiple programs or complex programs

Resources for Human Development is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, gender, gender identity, sexual orientation, national origin, genetic information, veteran, or disability status.

Responsibilities/Duties

  • Charge and Claim Processing –
  • Confirm that all services provided have been entered and/or tagged
  • Appropriately process all services to be billed
  • Timely file all claims -primary and secondary
  • Confirm successful transmission to the payors
  • Timely resolve any transmission errors (HIPPA Desk, Payor up-front rejections, etc)
  • Timely communicate un-billable claims to mitigate timely filing denials
  • Claim Resolution –
  • Follow-up with payers to resolve all re-submissions, rejections and appeals.
  • Communicate with insurance companies, program staff and other internal stakeholders to settle billing issues and resolve open claims
  • Work open claims systematically giving priority to aged claims to resolve balances in a timely manner
  • Respond to inquiries or follow up on issues and provide information to resolve outstanding balances
  • Apply payments received to the appropriate open ARs; correct any application errors
  • Provide required reporting of claims or service data to State funders and other payors
  • Partner with program personnel ensuring compliance with RHD Billing requirements or guidelines; makes recommendations and assists in implementation of recommendations
  • Assist with utilization review and authorization management
  • Create and provide reports to analyze billing and accounts receivable
  • Maintain Fee Schedules in billing software system
  • Complete all other duties as assigned

Required Experience

  • Minimum of 3 years work experience with accounts receivable, or financial analysis for healthcare, mental health and/or IDD billing systems experience in a high volume medical insurance billing setting.

Required Education

  • High School Diploma required.

Required Qualifications

  • Proficiency in Microsoft Office, Excel and Outlook
  • Ability to travel within the Divisional geographic area
  • Must be detailed oriented and must have the ability to complete tasks with little supervision.
  • Experience with Netsmart Avatar application is a plus.

Program Summary

Resources for Human Development is a national human services nonprofit with the broadest possible service mission, and specializes in creating innovative, quality services that support people of all abilities wherever the need exists. Founded in 1970 RHD supports more than 160 human service programs across the country, serving tens of thousands of people every year with caring and effective programs addressing intellectual and developmental disabilities, behavioral health, homelessness, addiction recovery and more.

Resources for Human Development

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