Medical Billing and Collections Specialist

About the Company:

Four Corners Health and Rehabilitation is a rapidly growing and established healthcare company providing in-home therapy and Home Healthcare. We are looking for the right individual to grow with us as we build a medical billing and accounts receivable department to handle 1,000 plus claims per week to meet expected future growth as well as normal follow-up on rejections and denials. Four Corners Health and Rehabilitation Inc. performs physical, occupational, and speech therapy in patient homes and assisted living facilities as well as revenue cycle management services to outside clients.

Job Summary:

The Billing Specialist team member is responsible for timely and accurate claims filing, review, and resolution of denied insurance claims. The Billing Specialist will review all pertinent information such as provider medical records, service claims, insurance carrier explanation of benefits, insurance carrier denial letters, and electronic remits to ensure that payments and denials are worked promptly and appeals for the denied claims are submitted appropriately. Billing Specialist will work with team and assist with payment posting, patient inquiries and other clerical duties as needed.

Supervisory Responsibilities:

• None.

Duties/Responsibilities:

• You must be able to operate and stay organized when using multiple computer screens and website windows.
• You must be adaptable to sudden changes that will occur due to changes in the medical regulations and processes.
• Submit and follow-up with Medicare, Commercial, Workers Compensation payers.
• Post payments and denials promptly in adherence to month-closing procedures.
• Process and follow up on payer denials, rejected claims, and appeals in a timely fashion.
• Follow up with the insurance companies for the status on claims.
• Work with patients to develop self-pay arrangements and payment plans.
• Work with other departments as necessary to resolve issues on accounts.
• Collect and post patient copays.
• Correct and/or appeal denied or rejected claims.
• Research and resolve incorrectly paid claims or issues.
• Notate patient accounts with up-to-date information.
• Other duties as assigned by management.

Required Skills/Abilities:

• Proven experience as a billing specialist in an environment with recurring charges such as Physical Therapy, DME, and Home Health.
• Ability to read and understand explanation of benefits, work on appeals, and claim denials.
• Knowledge of Medicare guidelines, Medicaid programs, and Managed Care.
• Experience with computerized billing systems, office equipment, and MS Office with an emphasis on Excel.
• Excellent written and verbal communication and customer service skills.
• Thorough understanding of denied claim follow-up and payment posting processes.
• Strong analytical skills and a high degree of accuracy.
• Ability to work independently.
• Exceptional time management skills.
• Attention to detail is a must.
• Detail-oriented with the ability to telecommute, and work in a fast-paced and busy environment.
• Adherence to HIPAA laws, HIPAA compliance workplace, best practices dealing with customers, data, and HIPAA compliance.

Education and Experience:

• Medical Back Office experience of at least 3 years.
• Experience with Therapy medical claims filing.
• Home Health Billing experience is desired.
• Familiarity with Insurance terminology and payment scenarios.
• Familiar with Office programs, Google Drive.
• High school graduate or equivalent.
• Previous experience with a remote work environment is a plus.

Physical Requirements:

• Duties require sitting, standing, talking, or listening.
• Requires close vision to the small print on computer screen or paperwork.

Job Type:

• Full-time
• Telecommuting – Must reside in Florida

Job Type: Part-time

Pay: $19.00 - $20.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Remote

Application Question(s):

• Do you live in the state of Florida?

Experience:

• Home Health billing and collections: 1 year (Preferred)

Location:

• Florida (Required)

Work Location: Remote