Claims & Billing Intern

JOB DESCRIPTION

Job Title: Claims & Billing Intern

Reports to: Director of Claims & Billing

Social Care Network Summary: The New York State Department of Health has established Social Care Networks
(SCNs) as part of the 1115 Waiver Demonstration Amendment, The SCN’s aim is to enhance the delivery of social care services to Medicaid members by coordinating efforts among community-based organizations (CBOs) and other health care partners to create a more resilient, flexible, and accessible social care system that reduces health disparities and advances health equity. The SCN will collaborate with CBOs and other health care partners, leveraging shared data and technology to coordinate social care services for Medicaid members to improve access, ensure reliable and timely referrals, streamline and track navigation and completed referrals in closed loop systems and enhance collaboration between social care service providers and other regional partners.

Job Summary: The Claims & Billing Intern supports the daily review of Social Care Network claims and billing related services, ensuring that claims are accurate, complete and can be processed for payment in accordance with program guidelines.

Organizational Overview: The Forward Leading Independent Provider Association (FLIPA) is a nonprofit membership association of safety net providers working in partnership to provide the highest quality healthcare to the most vulnerable populations in Upstate New York since 2017. FLIPA is renowned for its commitment to integrating primary care and behavioral health. Our growing membership includes a combination of federally qualified health centers (FQHCs), behavioral health providers, and a rural health network across more than 27 counties.

Equal Employment Opportunity Statement: At Forward Leading IPA (FLIPA), we deeply value diversity in background, experience, and thought. We are committed to creating an environment of belonging where all qualified applicants are encouraged to apply and will receive equal consideration for employment.

Security Level: Claims & Billing

Duties/Responsibilities:

• Review Social Care Network claims for accuracy
• Make decisions on claims approval or denial

• Verify member eligibility and compliance with program requirements
• Effectively communicate with provider partners on claims status

• Communicate effectively with partners and stakeholders through both written and verbal channels

• Assist with the development of billing invoices
• Review and manipulate excel reports related to claims and billing

• Other duties as assigned

Education & Experience:

• Minimum of High School Diploma or GED.
• Currently enrolled in a bachelor’s or associate degree program
• Majoring in a relevant field(e.g., Human Services, Health Administration, Social Work, Public Health, Communications, Nursing or other public health fields)

Skills, Knowledge, and Abilities:

• Excellent writing and organizational skills

• Proficient with Microsoft Office Suite, including Microsoft Teams
• Strong technology and computer skills; able to learn new software and applications quickly
• Flexible, adaptable style that takes in stride last minute changes and project pivots and thrives on creative problem-solving. Able to work quickly and efficiently

• Strong interpersonal skills, independently resourceful and thrive in a fully remote environment
• Demonstrated communication skills
• Information gathering and monitoring skills
• Problem analysis and problem-solving skills
• Sound judgment and decision-making ability

• Initiative to complete projects and tasks independently
• Attention to detail and accuracy
• Confidentiality

Salary Range:

• This position offers an hourly rate of $20.00

Additional information:

This position will be remote with periodic required in-person meetings.