Job Description

ESSENTIAL JOB RESPONSIBILITIES:

· Ensures reimbursement through efficient, accurate and timely billing process for effective accounts receivable management.

· Work pre-billing report for assigned payers in preparation for month end close.

· Generates claims for submission to payers in accordance with established schedule.

· Utilizes technology to manage clearinghouse and payor accept/reject submissions and reports timely.

· Responsible for accurate posting of cash payments and preparation of cash balancing process.

· Reviews A/R reports and researches unpaid claims. Takes necessary steps to collect unpaid claims and address credit balances. Provide reports to the Patients Account Manager as needed.

· Process correspondence and telephone calls from all payors regarding claims.

· Complete appeals on underpaid claims to the payer.

· Identify, prepare and submit patient account adjustments to Revenue Cycle Manager and post in Netsmart once approved.

· Assist as needed with payer authorizations and verification as required and completed documentation

in Netsmart.

· Protects the confidentiality of patient and organization information through effective controls and supervision of billing operations.

· The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND QUALIFICATIONS:

· High school diploma/GED required. Associates preferred.

· Two-to-four years' experience in health care billing and collections preferred.

· High school diploma required. Associates preferred.

· Billing information systems knowledge

· Working knowledge of home health, hospice and physician billing.

· Knowledge of Microsoft Excel.

· Knowledge of governmental regulations and billing guidelines.

· Demonstrates good communication skills.

· Demonstrated capability to accurately manage detailed information.

· Able to deal tactfully with patients, family members, referral sources and payers.

· Demonstrates autonomy, organization, assertiveness, flexibility and cooperation in performing job responsibilities.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.