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Third Party Billing Authorization Specialist

  • Chelsea, MA
  • Full Time (40 Hours)
  • Chelsea, MA

North Suffolk is looking for a Third Party Billing Authorization Specialist to join our team! The Third Party Billing Authorization Specialist will prepare, submit and collect of all claims including the coordination of all prior authorization requests and submissions.  They will also support the Authorization coordinator by monitoring, coordination, reporting and timely submitting all prior authorization requests for the Agency’s four mental health clinics.

What you’ll do:

  • Ensure that insurance claims are submitted by deadlines.
    • Coordinate all requests for prior approval as applicable.
    • Review and update clients’ eligibility status.
  • Maintain patient database, update ARPlus, and Ehana systems as needed.
  • Review aging reports and initiate/implement follow-up procedures and resubmit follow-up of all rejected claims.
  • Direct responsibility for the consistent review of the appropriate program(s) aging reports which include follow-up procedures via telephones and written communications to insurers and clients for claims not paid within sixty (60) days of submittal in order to facilitate applicable payment.
  • Enter and reconcile deposits for the Accounts Receivable Department.
  • Generate reports in excel for various functions and update authorization tracking reports as needed.
  • Monitor and track clinics’ initial and extended authorizations for date and unit/session exhaustion.
  • Run AR Plus authorization reports when needed to monitor and request authorizations from third party funders and confirm authorization receipt with online insurances.
  • Enter authorizations into AR Plus system. Ensure that all visits are properly linked to calculate correctly.
  • Responsible for improving and maintaining denials for authorization issues and for all follow-up authorization procedures in order to maximize collection.

What you’ll need:

  • Education: High School Diploma or GED required.
  • Experience: One (1) year of third party billing experience required. Knowledge of medical billing regulations needed.

Competitive & Comprehensive Benefits:

  • Paid Time Off Two weeks’ Vacation per year (three weeks after 2 years of service), 12 Sick Days per year, and 11 Paid Holidays per year
  • Health & Dental Insurance, with generous employer contribution
  • Employer Paid Life Insurance
  • 403 (b) Retirement Plan with employer matching
  • Voluntary Short and Long Term Disability Insurance
  • Medical & Dependent Care Flexible Spending Accounts
  • Access to Credit Union Banking
  • Access to State Tuition Remission Program (Worksite Specific)
  • Eligibility for the Public Service Loan Forgiveness Program
  • Employee Referral Bonus Program
  • Discounted Movie Tickets
  • Comprehensive Training Program
  • Internal Advancement Opportunities


Tagged as: Administration, Human Services, Social Work

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