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Medical Biller

South Shore Speech Language

  • Babylon, New York
  • 30+ days ago
  • $25 Per Hour

Highlights

4. CPSE (Pre‑School Special Education) Billing Handle billing through NYSED/NYCPSE mechanisms , often tied to Preschool Programs in Approved Settings (PPS or CPSE programs). Our practice features state-of-the-art care for speech, language, swallowing, and voice disorders, and offers a variety of highly specialized techniques and procedures that utilize the latest in technology.

Numbers & Facts

LocationBabylon, New York

Description

South Shore Speech is looking for a competent, responsible and dedicated individual to join our busy/fast paced, award winning team Benefits and Perks: . Family/friendly work environment . Supportive management and staff . Employee appreciation events regularly . Teaching/training will be provided Qualifications:
. Certified Professional Coder
. Proficiency with Excel . Motivated and possess the ability to multitask . Past medical office experience necessary . Strong organization skills . Able to interact well and professionally with the public both in person and over the phone
Responsibilities:
1. Pre‑Authorizations & Verifications
  • Contact payers (e.g. Medicaid, private insurances, NICU-funded programs) to verify patient eligibility and coverage before treatment begins.
  • Submit pre-authorization requests for services requiring prior approval (e.g. speech therapy visits under Early Intervention or CPSE).
  • Track authorizations, monitor denials, and coordinate with clinical staff to obtain additional documentation or clinical rationale when needed.
2. Insurance & Third‑Party Billing
  • Prepare and submit claims to insurance carriers, including Medicaid, commercial payers, and EMR-based Early Intervention systems.
  • Monitor claim status, follow up on unpaid or denied claims, and resubmit corrected or appealed claims as necessary.
  • Reconcile payments, post EOBs (Explanation of Benefits) and ERA (Electronic Remittance Advice) data.
  • Patient billing: handle co-pays, deductibles, and out-of-pocket balances; send statements or coordinate payment plans.
3. Early Intervention Program Billing (NY‑EI)
  • Maintain understanding of NY State Early Intervention billing codes, rates, and service models (e.g. 1:1 vs. group, telepractice).
  • Submit EI claims via the NYSED portal or billing platform used by Early Intervention providers.
  • Coordinate with Service Coordinators and Special Instruction to ensure approvals and proper authorization.
  • Address denials or adjustments typical to New York’s EI system, including eligibility updates and end-of-year reauthorizations.
4. CPSE (Pre‑School Special Education) Billing
  • Handle billing through NYSED/NYCPSE mechanisms, often tied to Preschool Programs in Approved Settings (PPS or CPSE programs).
  • Submit claims either directly or through school district billing systems (e.g. IU–ITP).
  • Keep tabs on student eligibility, service plans (IFSP to IEP transitions), and annual authorization renewals.
  • Coordinate with district CPSE liaisons and parents around covered services and parental consent.
5. Documentation, Compliance & Reporting
  • Maintain accurate documentation of claims, appeal letters, rejections, and patient eligibility.
  • Stay current with New York health regulations, Medicaid policies, and best practices for Early Intervention and CPSE billing.
  • Generate reports (e.g. productivity, claim success rates, aging schedules, AR reports) for practice management and financial tracking.
6. Coordination & Communication
  • Liaise with SLP clinicians, administrative staff, families, schools, and external coordinators (e.g. Service Coordinators, CPSE offices).
  • Provide timely feedback on coverage limits, benefit exhaustion, and parental financial responsibility.
  • Offer support to front-desk or intake team to collect necessary patient/payer information upfront (e.g. prior authorizations, CPSE numbers).
Compensation: $25.00 per hour

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