You haven't searched anything yet.
General Summary: The Private Duty Billing Specialist is responsible for timely and compliant Private duty billing, authorizations, and reimbursement for their designated region. The position will work directly with the Revenue Cycle Director, Billing Compliance Coordinator, Agencies and Intermediary to facilitate a fluid process of billing claims timely and successfully. This position will obtain authorizations as needed, prepare, audit, and submit claims electronically for appropriate payment. This position will be responsible for following up on outstanding claims, taking the appropriate action to ensure timely payment is received
Essential Functions:
1. Collect all the necessary information to prepare claims, coordinating with agencies when appropriate.
2. Bill and submit clean claims electronically and following up with Payer.
3. Process, collect and manage account payments.
4. Monitor claims daily, report totals
5. Research, correct, and re-submit rejected and denied claims.
6. Follow-up on corrections and report adjustments by utilizing revenue cycle management tool..
7. Monitor and maintain assigned accounts. Review billing reports to maintain accurate AR balances. Document all follow-up completed on the claim outstanding balance until final resolution is reached.
8. Keep accurate and orderly records for all billing and accounts receivable activity.
9. Pre-billing audits as assigned.
10. Proactive in identifying potential reimbursement issues, while ensuring effective problem resolution.
11. Coordinate with Agency and Billing Compliance Coordinator on any relevant process issue impacting billing so that a resolution can be established.
12. Report any billing issues that develop into trends to immediate supervisor.
13. Answer questions from patients, agency staff, and insurance companies.
14. Interpret and process Explanation of Benefits when needed.
15. Make outbound calls in a professional manner, while keeping and improving customer relations..
16. Maintain knowledge of current industry standards related to billing, cognizant of new regulations that impact billing. Prepare and implement any required change accordingly.
This description is a general statement of required essential functions performed regularly. It does not exclude other duties as assigned.
#FLHIGH
Requirements:Experience:
Skills:
Education:
Physical Requirements:
Environmental/Working Conditions:
Full Time
$38k-47k (estimate)
06/09/2024
10/05/2024