110 Best eligibility specialist Jobs in Long Beach, New York (September 2025)

Martin De Porres Youth & Family Services

Medical Billing Specialist

29 days ago

Springfield Gardens

Job DescriptionDescription: Job Title: Medical Billing Specialist Salary: $25-$30 per hour Supervisor: Director of Behavioral Health Services Department: Behavioral Health Services FLSA Status: Full Time – Exempt ========================================================================================== GENERAL DESCRIPTION: The Medical Billing Specialist coordinates with the Authorization & Payroll Specialist and Director of Behavioral Health Services to ensure all CFTSS and HCBS services are billed and adjudicated in accordance with the New York State Department of Health (NYSDOH) and federal regulations. The Medical Billing Specialist can work independently and efficiently under pressure. They conduct follow-up correspondence to resolve open and denied claims via email or on the phone. The Medical Billing Specialist may act as a liaison between MDPYFS and the MMCPs (Medicaid Managed Care Plans) that insure the clients on the Behavioral Health Services Department’s roster. They keep records organized and can complete tasks quickly and efficiently, in order of highest priority. MAJOR DUTIES AND RESPONSIBILITIES: • Verify clients’ eligibility weekly., • Maintain updated billing profiles for all clients in the clearinghouse database., • Report service provision overutilization including but not limited to fraud, waste, and abuse., • Process, correct, and rebill claims for adjudication using ICD-10 codes if necessary., • Audit Explanations of Payments (EOP) from MMCPs., • Reconcile incoming payments., • Resolve denied and underpaid claims via the dispute, appeal, or grievance process., • Liaise between NYS Medicaid programs and MMCPs., • Ensure ongoing communication with the Director of Behavioral Health Services regarding the escalation of service-impacting issues., • Develop and implement process improvement initiatives., • Perform ongoing independent research related to changes in industry standards., • Attend quarterly Department meetings to provide necessary feedback. EDUCATION: • At least two (2) years of administrative experience, • Excellent organizational, problem-solving, and time-management skills, • Detail-oriented and able to multitask, • Strong oral and written communication skills Section 424-A of the New York Social Services Law requires an authorized agency to inquire whether a candidate for employment with child-caring responsibilities has been the subject of a child abuse and maltreatment report. • Credential Verification, • Medical and Physical clearance, which includes TB screening, • State Central Registry (SCR) Clearance, • Staff Exclusion List (SEL), • Justice Center Background Check, • Mandated Reporter, • Trauma Informed Care, • Lasallian Culture of Care, • This is an in-person position., • The number of days will vary based on the agreed work schedule. The hours of work are up to forty (40) hours per week. This position may require long hours and occasional weekend work as the job demands. PHYSICAL REQUIREMENT: • Lifting requirement of 50 Lbs., • Ability to meet physical requirements of the position when performing the following: standing, walking, sitting, bending, stooping, squatting, kneeling, and climbing. Requirements: QUALIFICATIONS: EDUCATION: Bachelor’s Degree EXPERIENCE: At least two (2) years of administrative or supervisory experience At least two (2) years of medical billing experience Familiarity with billing and coding terminology REQUIRED SKILLS AND ABILITIES: Highly organized and detail-oriented Business Acumen Effective oral and written communication skills Consultation Relationship management Time management Data input Ability to communicate effectively with stakeholders Understanding and incorporation of the Lasallian Culture of Care as a work philosophy Ability to work varying hours as needed Proficient computer skills (Microsoft Word & Excel) Excellent problem-solving capability and ability to meet multiple deadlines under pressure ACTIVE CERTIFICATIONS: Mandated Reporter Lasallian Culture of Care (LCC) Required training as delineated by the oversight agency and or MDPYFS SUPERVISORY RESPONSIBILITY: This position may serve as a consultant and mentor in the agency. EXPECTED HOURS OF WORK: The number of days will vary based on the agreed work schedule. The hours of work are up to forty (40) hours per week. This position may require long hours and occasional weekend work as the job demands. BACKGROUND VERIFICATION and CLEARANCE: Section 424-A of the New York Social Services Law requires an authorized agency to inquire whether a candidate for employment with child-caring responsibilities has been the subject of a child abuse and maltreatment report. Credential Verification Medical and Physical clearance, which includes TB screening State Central Registry (SCR) Clearance Staff Exclusion List (SEL) Justice Center Background Check Required training as delineated by the oversight agency and or MDPYFS Reference Verification PHYSICAL REQUIREMENT: Lifting requirement of 50 Lbs. Ability to meet physical requirements of the position when performing the following: standing, walking, sitting, bending, stooping, squatting, kneeling, and climbing.

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