Program Administration Authorization and Billing Associate

Mentor South Bay, provides Early Intervention, Applied Behavioral Analysis (ABA), Behavioral Health and Mental Health Outpatient services across Massachusetts and Connecticut. For over 35 years, we’ve provided a collaborative, team-based approach dedicated to helping children, adults, and families reach their fullest potential. If you are passionate about making a difference in the lives of individuals and families, join our mission-driven team and experience a career well lived. Program Administration Authorization and Billing Associate Do you want a job where you can use your background in medical administration/billing and make a positive difference in people’s lives? As Authorization and Billing Associate, you will serve as the liaison between the Operations and Finance departments and be responsible for all revenue recognition for each person served, as well as for obtaining authorizations and performing eligibility checks.

• Work with the program proactively to obtain eligibility and initial authorizations for all new admissions and “unfunded” persons served Utilize the main billing systems (Avatar & iServe) to capture service entry, admissions, discharges, and transfers prior to billing
• Review eligibility and submit requests to the SSC to update payer information and/or changes
• Manage and proactively obtain information on subsequent authorizations for all persons served until discharged; submit to the SSC for processing
• Review attendance and meal counts for accuracy prior to charge entry; maintain supporting documentation (attendance, meal counts, and reconciled Trended Units Report) for service entry
• Reconcile weekly and monthly service capture for all payers/individuals prior to billing
• Participate in weekly/monthly AR calls, providing an overview of authorization and eligibility issues
• Provide information to be used in the quarterly reserve process as needed
• Ensure internal control compliance by adhering to audit requirements within all assigned areas, including maintaining an effective control environment which complies with external regulations
• Assist with the resolution of any issues that could impact the timing of month-end close
• Assist in the on-boarding of new hires by providing required training when necessary
• Perform timely updating and modification of control design where necessary; oversee control remediation activities should exceptions be encountered in testing

Qualifications

• High school diploma or equivalent required; Associate or Bachelor’s degree preferred
• Minimum of one year of experience in the medical administration field and/or medical billing
• Experience with a payer online portal and knowledge of EDI 835 formatting preferred
• Proficiency with Microsoft Word, Excel, and Outlook
• Detail-oriented with ability to multitask
• Demonstrated skills in communication, problem-solving, and data entry
• Excellent communication skills with ability to respect and build rapport with others
• Commitment to excellent customer service and support

Why Join Us?

• Full compensation/benefits package for full-time employees.
• 401(k) with company match
• Paid time off and holiday pay
• Important work adding value to the organization’s mission alongside a great team of coworkers
• Enjoy job security with nationwide career development and advancement opportunities

Come join our amazing team of committed, caring professionals. Apply Today! Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face. We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S. As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law Apply tot his job Apply To this Job