Overview
Schedule
Alternate-schedule
Full-time
Education
Medical Coding (CCA, CCS, CCS-P, CPC)
Career level
Senior-level
Remote
On-site
Compensation
$25+/hour
Benefits
Career Development
Job 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
About South Shore Speech, Language and Swallowing Disorders
South Shore Speech, Language and Swallowing Disorders, PLLC is one of the most comprehensive speech therapy practices on Long Island. We offer the convenience of a large group practice, with daily and occasional weekend hours and prompt appointment scheduling. 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.
Our mission is to provide quality, comprehensive, and easily accessible services in a manner that reflects culturally competent care and innovative treatment.
Our goal is to provide experiences that enable the individual to develop to his/her greatest potential so that he/she could become functional within their respective environment.
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FAQs About Medical Biller Jobs at South Shore Speech Language
What is the work location for this position at South Shore Speech Language?
This job at South Shore Speech Language is located in Babylon, New York, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at South Shore Speech Language?
Candidates can expect a pay range of $25 (per hour).
What employment applies to this position at South Shore Speech Language?
South Shore Speech Language lists this position under the following employment categories:
- Alternate-schedule
- Full-time
What experience level is required for this role at South Shore Speech Language?
South Shore Speech Language is looking for a candidate with "Senior-level" experience level.
What education level is required for this job?
The education requirement for this position is Medical Coding (CCA, CCS, CCS-P, CPC). Candidates with relevant qualifications or equivalent experience may also be considered.
What benefits are offered by South Shore Speech Language for this role?
South Shore Speech Language offers Career Development for this position. Actual benefits may vary depending on the employer's policies and employment terms.
What is the process to apply for this position at South Shore Speech Language?
You can apply for this role at South Shore Speech Language either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.