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About the Role

This position is responsible for all revenue cycle management for the DART program, ensuring timely, accurate, and compliant reimbursement for services incurred by patients and clients.

Responsibilities

Oversee all revenue cycle processes including: monitoring and managing patient insurance eligibility, assisting patients to obtain/recertify insurance, monitoring and managing provider credentials, reporting data to insurers, acting as a liaison with managed care organizations for contracting, credentialing, and issue resolution, obtaining authorizations and referrals for services, configuring the electronic health record system and excel billing tools, generating billing data, submitting claims accurately and timely, managing accounts receivable, addressing claim denials and underpayments, collecting payments from clients, and reconciling payments.
Maintain understanding of NYS OASAS, Medicaid, and insurance payer billing rules and regulations.
Develop, maintain, and implement policies and procedures for revenue cycle management.
Prepare billing and revenue reports and assist with month-end closing and audit reports.
Ensure compliance with confidentiality, billing regulations, and organizational policies.
Perform supervisor responsibilities by overseeing daily operations, recruiting, training, monitoring performance, and ensuring workplace policies and standards are followed.
Monitor and manage vendor performance.
Present a professional image in conduct, attitude, and attire.
Complete mandatory trainings.
Perform additional duties as assigned.

Requirements

Bachelor’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or related field, or equivalent experience.
Minimum of five (5) years of healthcare billing experience including Medicaid, Medicare, and commercial insurance.
Minimum of two (2) years supervisory experience.
Must present a professional image in conduct, attitude, and attire.
Satisfactory completion of mandatory trainings.
Physical examination record or pass physical examination by a CAO physician.
Valid NYS Driver’s License and proof of motor vehicle insurance coverage.
Completion of CAO Employment application.
Completion of NYS SCR Clearance Form with acceptable clearance.
Completion of Criminal Record Certification and free of criminal convictions of crimes against children (misdemeanor or felony).
Fingerprinting required.
Release for Reference Checks.

Skills

Strong commitment in maintaining confidentiality.
Proficient in Microsoft Office Suite.
Proficient in billing software and electronic health record systems.
Experience in New York State substance use treatment billing, including opioid treatment program preferred.
Strong knowledge of revenue cycle management, accounts receivable, billing regulations, and reimbursement processes.
Ability to communicate complex issues and advocate for the organization’s interests with external stakeholders such as insurance companies.
Excellent analytical, organizational, communication, and problem-solving skills.
Strong attention to detail.
Must be self-motivated and able to implement and maintain processes.
Ability to write reports and correspondence.
Ability to read and interpret documents such as medical billing procedures, operating and maintenance instructions, and procedure manuals.
Ability to perform computations rapidly and accurately, compile statistical reports, and apply concepts such as fractions, percentage, ratios, and proportions.
Strong understanding of the conventions of the medical coding system.
Working knowledge of CPT, HCPCS, and ICD-10 coding as applied to substance use disorder / OTP billing.
Familiarity with OASAS and NYS Medicaid billing portals, eMedNY, and clearinghouse claims systems.
Skilled in identifying, researching, and resolving claim denials, rejections, and underpayments.
Working knowledge of HIPAA privacy and security requirements and 42 CFR Part 2 confidentiality regulations for substance use treatment records.
Intermediate to advanced Excel skills (formulas, pivot tables, reconciliation workbooks) for tracking and reporting billing data.
Experience with electronic health record (EHR) and practice management systems, including configuration of billing and coding workflows.
Ability to interpret payer contracts and managed care agreements.
Strong vendor management skills, including monitoring outsourced billing performance against service-level expectations.
Effective leadership and staff development skills, including training non-billing staff on documentation requirements that affect reimbursement.
Requires patience and the ability to focus.
Ability to read and write, speak and listen.
Use of hands is required for tasks such as typing, writing, handling documents, and using office equipment.
Specific vision requirements include close vision, peripheral vision, and the ability to adjust focus.
Ability to lift/move up to 25 pounds.

Location

Buffalo, NY 14209

Work Type

Full Time

Experience Level

Minimum of five (5) years of healthcare billing experience
Minimum of two (2) years supervisory experience

Education Level

Bachelor’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or related field, or equivalent experience.

Salary/Compensations

$65,000.00 - $70,000.00 Salary/year

About the Company

CAO of WNY, Inc. is an equal opportunity employer.

Equal Opportunity

CAO of WNY, Inc. is an equal opportunity employer.