Billing Specialist

Description

The Billing Specialist is responsible for processing all private insurance, Medicaid, and unrelated drug claims. The Billing Specialist is responsible for follow-up and collections on accounts. They will maintain accurate patient reimbursement data and ensure compliance with regulations and Community Hospice billing procedures.

Responsibilities

• Responsible for obtaining preauthorization for insurance eligibility and benefits upon admission and level of care change.
• Responsible for processing private insurance billing.
• Responsible for processing insurance co-pays and deductibles.
• Responsible for follow-up on insurance denials and collections on accounts.
• Ensures billing is performed timely and accurately.
• Assists with and follows up on Medicaid pending applications.
• Responsible for processing Medicaid Claims
• Responsible for follow-up on Medicaid denials and collections on accounts.
• Processes unrelated drug claims. Ensures unrelated drug charges are billed promptly and accurately.
• Ensures billing is performed timely and accurately.
• Responsible for ensuring compliance with CPT, MCPES & ICD-10 coding of all ARNP/MD claims prior to billing.
• Review all ARNP/MD visit narratives and assign codes for services rendered.
• Conduct audits and coding reviews to ensure all documentation is accurate and precise.
• Comply with all legal requirements regarding coding procedures and practices.
• Monitors accounts receivable, maintains aging of accounts within agency goals.
• Ensure collections on accounts are routinely performed for each reimbursor. Denials are monitored and reviewed.
• Verifies nursing home billing rates are accurate and patient liabilities are recouped.
• Demonstrates knowledge and understanding of hospice reimbursement and billing procedures. Able assist Billing Coordinator or perform billing in her absence.
• Works with MRS to ensure patient financial information and level of care changes are obtained and verified to ensure prompt collections with appropriate financial sources.
• Processes Electronic Medicare election submissions when needed.
• Ensures ledger cards are accurate and level of care changes are made.
• Prepares billing reports for Billing Coordinator and CFO as needed.
• Perform other duties as assigned.
  
  

Job Type: Full-time

Expected hours: 32 per week

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Paid time off
• Tuition reimbursement
• Vision insurance
  
  

Schedule

• 8 hour shift
• 4 days a week.
  
  

Work Location: In person

Requirements

QUALIFICATIONS:

• College degree or Degree of Certification in Medical Coding/ and/or three years
  
  

billing experience.

• Knowledge and experience with Medicare, Medicaid, and private insurance billing procedures.
• Good organizational, interpersonal and communication skills.
• Knowledge and understand of modern office practice and procedures.
• Ability to organize and assess.
• Must demonstrate effective communication skills
• Must be able to work independent of direct supervision.
• Must be able to pass a Driving Records Check, Criminal Background Check, and a Pre-Employment Drug Screen.
  
  

Education

College degree or Degree of Certification in Medical Coding (Required)

Experience

3 years (Required)