Healthcare Billing Analyst - Research Foundation for Mental Hygiene, Inc.

October 2024

POSITION ANNOUNCEMENT

Healthcare Billing Analyst

Salary Grade: 18

Full Time salary range: $61,811 - $70,591

The Research Foundation for Mental Hygiene, Inc. (RFMH) is currently seeking a qualified candidate to serve as a Grade 18 Managed Care Billing Analyst at the Office of Mental Health in Albany, New York.

Function and Scope

The Strategic Finance & Managed Care (SFMC) Group, Bureau of Managed Care Finance and Data Analytics is recruiting to fill a Managed Care Billing Analyst position. The SFMC Group monitors the managed care service-delivery and payment system for mental health, evaluates health plans' performance, and calculates and implements the rate for the services delivered by OMH licensed providers in both Fee-for-service and Managed Care (Medicaid and Commercial) systems. The incumbent of this position will work among a multidisciplinary team in the Managed Care Finance and Data Analytics Bureau, which is responsible for numerous fiscal and billing related activities within the Commercial and Medicaid managed care payer system. The successful candidate must have a least one year of experience with Microsoft Office products (Word, Excel, Outlook, etc.).

The Candidate may be required to interact with internal and external organizations (e.g., OMH financial, program and clinical staff, other NY State government agencies, and health insurance plans) so strong written and oral communication skills are required. The incumbent must have the working knowledge of the Microsoft Office Suite, practice good organizational and interpersonal skills, and be able to work within established deadlines.

Duties and Responsibilities

Job duties and responsibilities include but are not limited to the following:

• Monitor, track, and respond to inquiries OMH received pertaining to Commercial and Medicaid managed care billing.
• Support the Bureau by helping to organize meetings with other NYS human service agencies including OASAS, DOH, DFS as well as other Divisions within OMH on managed care related billing issues.
• Assist in creating communications originating from the Finance and Data Analytics Bureau, including guidance, policies, and presentations issued to providers and commercial insurers related to billing and claims.
• Help review State and Federal healthcare and Medicaid statutes, regulations, and policies to identify pertinent billing and finance related issues and assess their programmatic and financial impact on NYS behavioral health managed care.
• Assist in preparing briefings for key executive leadership on Managed Care issues related to claims denials, provider viability, or member access issues.
• Perform other duties as assigned.

Minimum Qualifications

• Bachelor's degree from an accredited college AND at least 1 year of experience working in health administration, medical billing, or other related fields.

Preferred Qualifications

• At least 1 year of experience working in State agencies that oversee government-funded insurance (i.e., Medicaid and Medicare) or commercial insurance.
• At least 1 year of experience with health care billing to insurance plans in an automated environment.
• Medical billing specialist certification or medical billing experience.

Working Location: 44 Holland Avenue, Albany, NY

To Apply: Submit an application through our website at https://rfmh.applicantpro.com/jobs/. Please note only applications submitted through our website will be considered.

The Mission of the Research Foundation for Mental Hygiene, Inc. (RFMH) is to promote the mental health of all New Yorkers, with a focus on providing hope and supporting recovery for adults with serious mental illness and children with serious emotional disturbances. Applicants with lived mental health experience are encouraged to apply. RFMH is deeply committed to supporting underserved individuals, organizations, and communities. To this end, RFMH is focused on implementing activities and initiatives to reduce disparities in access, quality, and treatment outcomes for underserved populations. A critical component of these efforts is ensuring that RFMH is a diverse and inclusive workplace where all employees' unique attributes and skills are valued and utilized to support the mission of the Agency. RFMH is an equal opportunity/affirmative action employer.

The Research Foundation is a private not-for-profit corporation and is not an agency or instrumentality of the State of New York. Employees of the Research Foundation are not state employees, do not participate in any state retirement system, and do not receive state fringe benefits. Excellent Benefits Package. Employer/Minority/Women/Disabled/Veteran Employer. VEVRAA 41 CFR 60-300.5(a) compliant.