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About the Role

Transitional Services for New York, Inc. (TSINY) seeks a Billing Team Leader for their Administrative office in Whitestone (Queens), NY. TSINY is a non-profit mental health services agency. This role will work closely with the Senior Fiscal Director-Residential & Billing to lead the revenue cycle management process, maintain working knowledge of current coding terminology, HIPPA and other Health Administration regulations, and direct the billing department.

Responsibilities

Supervise and manage all billing operations, including Medicaid, Medicare, Managed Care, and Third-Party Insurance.
Utilize resources like eMedNY, Inovalon, Availity, AWARDS, and payer portals to obtain billing documentation and process claims.
Oversee the entire claim's lifecycle from charge entry, submission, payment posting, to denial management and appeals.
Understand internal billing process details, including claim processing, revenue projections, payment posting, claim follow-up, and third-party collections.
Maintain accurate medical billing record files and ensure coding accuracy for claim submissions.
Manage denied claims, resolve discrepancies, and work with program administration to rectify them.
Maintain relationships with payers, understand their billing guidelines, and appeal processes.
Track changes in procedure codes, rate codes, and amounts, staying updated on coding and reimbursement rules.
Produce and analyze Accounts Receivable Aging Reports and advise on potential bad debts.
Identify and recommend improvements for billing efficiency and compliance.
Serve as the primary liaison between clinical providers, program administrative staff, and the billing department.
Supervise, manage, and mentor billing staff, monitoring performance for quality and productivity.
Assist billing staff with troubleshooting billing and coding issues.
Ensure staff receive training and educational opportunities.
Hire, counsel, and recommend disciplinary action for billing staff.
Provide auditors with requested billing reports at year-end.
Provide requested information to supervisors, management, or co-workers promptly.
Serve as back-up for any member of the Billing team.
Maintain an accurate inventory of billing files and ensure proper disposal.
Support the mission, values, and vision of the organization.
Promote positive public relations with residents, family members, and guests.
Complete in-service training requirements, maintain acceptable attendance, and adhere to uniform and dress codes.
Solve complex problems and deal with a variety of issues.
Effectively present information and respond to questions from various stakeholders.
Communicate sensitive information to principals and clients.
Perform other related duties as required.

Requirements

Detailed oriented.
Able to work independently and take initiative.
Knowledge of Medicare and Medicaid regulations.
Thorough knowledge of Microsoft Excel and ability to create and maintain spreadsheets.
Experience with AWARDS software.
Experience with Millin billing software.
Understanding of medical coding systems affecting adjudication of patient accounts in EDI, UB04 or 1500 forms.
Experience with third-party claim resolution processes, including denials and appeals management.
Ability to multi-task and meet deadlines.
Effective oral and written communication skills.
Ability to interact effectively with all levels of employees and external contacts.
Ability to handle confidential and sensitive information.
Manual dexterity for computer, telephone, fax, or copy machine use.
Ability to prepare clear, concise reports.
Ability to plan, assign, and direct the work of others.
Ability to communicate effectively orally and in writing.
Ability to lift items up to 25 pounds.
Ability to sit or stand as needed.
May require walking for short periods.
Ability to reach above shoulder heights, below the waist, or lift as required to file documents or store materials.
During a declared disaster, assume and adhere to assigned Job Action role(s).
Attend job and Agency trainings as required.
Minimum qualifications may be waived in unusual circumstances with approval of the CEO as long as City and State requirements are met.

Skills

Revenue cycle management
HIPAA
Health Administration regulations
Medicaid billing
Medicare billing
Managed Care billing
Third-Party Insurance billing
eMedNY
Inovalon
Availity
AWARDS
Payer portals
Claim submission
Payment posting
Denial management
Appeals
Medical billing record maintenance
Coding accuracy
Accounts Receivable Aging Reports
Billing efficiency improvement
Compliance
Workflow bottleneck resolution
Staff supervision
Staff management
Staff mentoring
Performance monitoring
Quality assurance
Productivity management
Troubleshooting billing issues
Troubleshooting coding issues
Staff training
Staff development
Hiring
Counseling
Disciplinary action
Auditor reporting
Information provision
Team backup
File inventory management
File disposal
Microsoft Excel
Medical coding systems
EDI
UB04 forms
1500 forms
Third-party claim resolution
Multitasking
Deadline management
Oral communication
Written communication
Interpersonal skills
Confidentiality
Problem-solving
Presenting information
Responding to questions
Communicating sensitive information

Location

Whitestone (Queens), NY

Work Type

Full-time

Experience Level

5–7 years’ progressive work experience in medical billing and revenue cycle management
2-3 years in behavior health or psychiatric setting
Previous management experience required

Education Level

Bachelor’s degree in Business, Healthcare Administration or commensurate experience in healthcare industry
Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) preferred
Accounting/Finance degree a plus

Salary/Compensations

$75,000

Benefits

Medical
Dental
Vision
Pension
403(b)
EAP
Disability Insurance

About the Company

Transitional Services for New York, Inc., is a not-for-profit comprehensive, community-based mental health organization located in New York City.
We provide a continuum of rehabilitative services to enrich the lives of those recovering from mental illness and facilitate their transition to increased levels of independence.
Transitional Services for New York, Inc. envisions broadening its rehabilitative services and becoming a regional social service provider.
Transitional Services for New York Staff will deliver effective programs with compassion, integrity, and professionalism.
We expect all staff to put our clients’ needs first while respecting ourselves and each other as we provide hope to those who participate in our programs.