ADS Billing and Payroll Specialist

DePaul Community Resources

2d•Hybrid

About The Position

The ADS Billing and Payroll Specialist position supports the Finance Department and Operational staff in the Agency Directed Services (ADS) Division. This position is responsible for the daily billing and collections for ADS and associated payments to Caregivers. The ADS Billing and Payroll Specialist will also play a critical role in supporting the Medicaid/MCO service authorization process and maintaining accurate credentialing records for ADS within our organization as needed. The ADS Billing and Payroll Specialist will maintain all payable records for all Caregivers, as well. The ADS Billing and Payroll specialist must build relationships and work with all Finance team members, other DePaul staff at all levels of the organization, and multiple partner agencies and third-party payors of DePaul’s services. This position is primarily remote work, but must be able to commute to the Roanoke office twice per week if needed.

Requirements

High school diploma or G.E.D. required.
Experience working with Medicaid regulations, preferably in service authorization, credentialing, and billing.
Successful completion (per DePaul's policies) of a Motor Vehicle Record, Criminal and Child Protective Services Background Report, and Drug Test is required. An unsatisfactory result of any of these tests will terminate the application process.

Nice To Haves

Preferred education in Healthcare Administration, Human Services, or a related field, or equivalent work experience.

Responsibilities

Collaborate and work cross-functionally with other finance and ADS Program staff to ensure billing is complete, accurate, and collectible.
Complete / Upload billing for ADS in Sage 100 weekly.
Ensure accurate and timely weekly submission of applicable ADS billing to all third-party payers (Medicaid, MCOs, individual clients, etc.).
Process cash receipts in Sage 100 for ADS daily.
Monitor Accounts Receivable and take necessary steps to collect outstanding balances.
Work with all payers, including insurance carriers, other organizations, DePaul staff, and clients, to resolve billing issues promptly.
Research any past-due balances, unpaid and underpaid; follow up on any denials of payment and determine a resolution that includes corrected claims, disputes, and appeals.
Communicate with ADS staff regarding denials that require client intervention to receive reimbursement.
Ensure all paperwork for ADS Caregivers regarding compensation is acquired and maintained in accordance with approved policies and procedures.
Review EVV time punches for accuracy related to approved Service Authorizations and related scheduling.
Present payment information to ADS leadership for review and approval prior to processing associated payments.
Prepare and upload payment information for ADS Caregivers into Sage 100 on an as-needed basis.
Work with DePaul Accounts Payable to ensure payments are made in accordance with the approved payment schedule for ADS Caregivers.
Act as a main point of contact for questions related to the billing or payment of services for ADS.
Communicate effectively with internal teams and external agencies to resolve authorization or credentialing issues.
Collaborate with other departments to streamline processes and improve efficiency in authorization and credentialing workflows, as well as associated billing and payments.
Assist with the authorization process for services rendered to Medicaid and MCO beneficiaries.
Collaborate with ADS Staff to gather necessary documentation for authorization requests, when needed.
Monitor authorization timelines and ensure adherence to regulatory standards.
Keep abreast of changes in Medicaid and MCO regulations and update internal processes accordingly.
Assist with the ADS credentialing and re-credentialing processes for DePaul Community Resources in accordance with Medicaid and MCO regulations, when needed.
Monitor and adapt to changes in Medicaid and MCO policies, procedures, and requirements related to credentialing.