Billing Specialist

Description

The Billing/Accounts Receivable Specialist ensures the accurate and timely submission of billing for Medicare, Medicaid, private payers, and patients. This role also involves following up on outstanding accounts receivable to collect payments and resolve any issues that may result in unbilled claims.

ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES

1.    Processes and bills Medicare, Medicaid, private payer, and patient claims, adhering to payer requirements and organizational policies.

2.    Keeps precise billing and accounts receivable records.

3.    Notifies the appropriate management team regarding any late or missing documents needed for billing.

4.    Capable of understanding and interpreting information in explanations of payments or benefits.

5.    Aids in receivables collection by monitoring accounts, resubmitting bills to overdue accounts, and notifying the Billing management team of seriously overdue accounts.

6.    Builds and sustains positive relationships with team members, patients, payers, and other customers.

7.    Possess strong knowledge of HIPPA compliance and consistently maintains the confidentiality of patient and organizational information.

8.    Undertakes additional projects related to billing, data entry, and company operations as needed.

The statements above are intended to summarize the primary duties and responsibilities of this job. Additional job-related responsibilities not listed here may be required to fulfill essential job functions upon hire.

Qualifications

POSITION QUALIFICATIONS

1.    A minimum of two (2) years of experience in home health care systems.

2.    A minimum of one (1) year of experience in healthcare billing, with a preference for home health care billing.

3.    Up-to-date knowledge of PDGM and NOA billing requirements for Medicare. 

4.    High school diploma or equivalent required; two (2) years of college education preferred.

SKILLS REQUIRED
•    Microsoft products (Excel, Work, Outlook) and Foxit or Adobe PDF
•    Knowledge of Insurance portals (i.e., Epic, Waystar aka Zirmed, Availity, eServices)
•    Knowledge of Kinnser/Wellsky EMR system
•    Good working knowledge of different Insurance/non-Insurance Plans (i.e. Commercial payers [Aetna Signature Administrators, Cigna, QCP, UHC, etc.], Liabilities, VA, etc.)

•    Knowledge of processing Medical Records
•    Strong organizational skills and attention to detail 
•    Efficient multitasking and time management skills 
•    Effective verbal and written communication skills
•    Ability to work effectively with other team members and independently

•    Initiative-taking

•    Quick-learning and problem-solving skills