Billing Specialist

About Carisk Partners, Inc.

Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors and other managed care organizations. Through its Pathways 2 Recovery care model, Carisk Partners aims to improve outcomes and reduce overall cost of quality care by applying best practices in a patient – centered approach to manage complex challenges for the group health, casualty and auto markets.

Role Overview

This role is responsible for the preparation of financial and management reports; assisting in monitoring and analyzing data submissions versus Provider invoices; reviewing and processing billing submissions from DCF Network Providers to the Managing Entities (ME); validating billing with data and supporting documentation; preparing and reviewing data validation reports; preparing reports with the result of the reviews; and providing technical assistance and trainings to the Provider Network.

This role also includes managing the day-to-day financial and accounting activities of the Department of Children and Families DCF / Managing Entity (ME), as well as the preparation of fiscal year budgets. Additionally, the position is responsible for the oversight of provider corrective actions related to billing compliance and integrity. As well as performing all financial reconciliation activities.

Role Responsibilities

• Responsible for the planning and execution of all tasks and deliverables of DCF / ME Billing Team.
• Supervise the monthly processing of Providers' billing, which includes but is not limited to; reconcile invoices with approved rates, approved funding, supporting data, authorizations, and certifications.
• Plan the billing process and send emails with instructions to providers and staff.
• Responsible for producing all reports with the results of the monthly billing and year end results.
• Provide assistance to each ME with the production and reconciliation of ME Monthly Reconciliation to DCF.
• Produce Financial Reports at the end of each Billing Cycle.
• Participate in meetings with ME Staff to discuss billing related issues.
• Provide technical assistance and training to Providers related to invoices and supporting data submission.
• Participate in Provider Meetings.
• Respond to inquiries from Providers and MEs regarding billing and manage the billing email accounts (billing@).
• Ensure that database and configuration of Carisk Apps, PCM, Share Point and other systems are updated.
• Respond to inquiries from all monitors and auditors.
• Review of client eligibility and TANF certification.
• Coordinate the implementation of updates and changes in the billing process

Role Qualifications

Culture and Benefits at Carisk :

Carisk Partners provides equal employment opportunities to all employees and applicants for employment, and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

The pay range for this role is :

50,000 - 60,000 USD per year(Tampa Office)

50,000 - 60,000 USD per year(Miami HQ Office)

50,000 - 60,000 USD per year(Jacksonville Office)

50,000 - 60,000 USD per year(Remote (Florida, US))

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