MA Billing Clerk (Clerk)

At the present time, a vacancy exists for a MA Billing Clerk within our Home and Community Services department in our Student Services division here at the Chester County Intermediate Unit. The MA Billing Clerk is responsible for reviewing, verifying, researching, correcting, and processing billing related to behavioral health and related services. The position ensures accurate and timely billing to Medical Assistance, Managed Care Organizations, third-party insurance carriers, school districts, and other funding sources. Responsibilities include accounts receivable functions, eligibility verification, claim research and correction, maintenance of confidential records, and support to staff, families, and stakeholders regarding billing procedures and requirements. Are you motivated to create brighter futures for students, families, and the entire community? If so, we want you on Team CCIU! At the CCIU, we pride ourselves on the creativity, dedication, and collaborative spirit that our employees bring to their work every day, and we know that achieving success together takes a team approach! If you are looking for an exciting, challenging opportunity to grow your career, don't wait – apply today to make Team CCIU even stronger tomorrow! Qualifications High school diploma required, preferably with coursework emphasizing database management, business operations, accounting, or related areas. Prior insurance billing experience required; experience with Medical Assistance, managed care claims processing, or behavioral health billing preferred. Medical Assistance Preferred KnowledgeBehavioral Health Rehabilitation Services (BHRS)/IBHSManaged Care Organizations (MCOs)Commercial insurance billingCoordination of Benefits (COB)Timely filing requirementsAuthorization requirementsRevenue cycle workflows Essential Job Responsibilities Review, verify, research, and correct documentation submitted by program staff to include the case managers and case specialists in accordance with Medical Assistance (MA), Third Party Liability (TPL), payer requirements, and CCIU policies and procedures. Build, review, and submit claims for IBHS, Reach/Teach/Care, Adult Services, and other Home & Community Services programs according to established billing schedules and payer requirements. This includes claim generation, reporting, claim submission, and transmission of electronic claim files through clearinghouses and other payer systems.Perform monthly Adult Services claim builds, claim reporting, claim submissions, and 837 electronic claim submissions by the fifth business day following month-end. Monitor and resolve claim issues prior to submission and communicate corrections needed to program staff and supervisors. Process bi-weekly appointment transitions, claims submissions, and clearinghouse submissions for IBHS, Reach, Teach, and Care programs, adjusting schedules as needed to meet organizational and payer requirements. Submit payer-specific paper claims and rebills as required, ensuring compliance with timely filing requirements and payer-specific billing guidelines.While maintaining compliance with HIPAA, CMS, Pennsylvania Medical Assistance regulations, managed care requirements, payer policies, and organizational procedures.Monitor, research, and resolve 837 front-end claim rejections, clearinghouse rejections, billing exceptions, and claim processing errors to ensure successful claim adjudication. Retrieve electronic remittance advice (835) files and payment information from all available payment sources; manually import 835 remittance files into the electronic medical record (EMR) system when necessary. Review, reconcile, and post electronic remittance information to ensure accurate payment application and financial reporting.Process manual and electronic payment postings, including ACH payments, EFTs, checks, and manual check postings. Perform daily payment reconciliation to ensure all deposits, payments, adjustments, and remittance information are accurately reflected within the EMR, billing systems, and financial records. Research and resolve payment discrepancies in collaboration with the Business Office.Review denials, Explanation of Benefits (EOBs), and payment variances; research claim issues and complete corrected claims, rebills, and payer follow-up activities within payer timely filing guidelines. Perform accounts receivable functions, including tracking outstanding balances, working aging reports, identifying claim payment issues, and ensuring timely reimbursement from Medical Assistance, Managed Care Organizations, third-party payers, school districts, and other funding sourcesMaintain and update departmental cash flow workbooks, billing logs, check posting logs, claim submission tracking reports, accounts receivable reports, and other revenue cycle reports. Perform daily reconciliation of cash receipts between the Billing Department and the Business Office, ensuring ACH payments, manually imported 835 remittance files, manual check postings, and other payment activity are accurately balanced and reflected in financial tracking systems.Verify eligibility and insurance coverage using available eligibility verification systems and conduct research to resolve coverage discrepancies. Maintain accurate and confidential client insurance and billing records in compliance with HIPAA, payer requirements, and organizational policies. Communicate with families, insurance companies, Managed Care Organizations, state agencies, and internal staff regarding billing issues, payment concerns, claim status, and documentation requirementsProvide technical assistance and training regarding billing processes, claim requirements, insurance regulations, and documentation standards to program staff and stakeholders. Maintain productivity and accuracy while meeting strict billing deadlines, reimbursement timelines, and organizational performance expectations. Establish and maintain professional working relationships with provider representatives, Managed Care Organizations (MCOs), Medical Assistance, commercial insurance carriers, clearinghouses, school districts, and other funding sources. Communicate regularly to research and resolve claim issues, payment discrepancies, eligibility concerns, authorization questions, denials, refunds, and other billing-related matters to facilitate timely reimbursement.Research and process payer refunds, overpayments, recoupments, and refund requests in accordance with payer requirements and organizational policies. Maintain appropriate documentation, obtain required approvals, and coordinate with the Business Office to ensure accurate financial reporting and reconciliation.Perform other duties as assigned to support departmental operations and organizational objectives. Hourly Rate (2026-2027 SY) Support Staff, Level 10, Nonexempt: $22.50/hr. to $29.82/hr. rate is determined by years of experience in a similar role SCHEDULE: Monday - Friday; 7.5 hrs/day; 260 days/year Start Date: October 2026 MS Equal Opportunity Employer Chester County Intermediate Unit is an Equal Opportunity Employer. Chester County Intermediate Unit ensures equal employment opportunities regardless of race, creed, gender, color, national origin, religion, age, sexual orientation or disability. Chester County Intermediate Unit has a policy of active recruitment of qualified minority teachers and non-certified employees. Any individual needing assistance in making application for any opening should contact the Department of Human Resources at 484-237-5085.