What are the responsibilities and job description for the Medicaid Coinsurance Biller position at CommuniCare Corporate?
CommuniCare Corporate -
Medicaid Coinsurance Biller
CommuniCare Health Services is currently recruiting a Medicare Coinsurance Biller for our Central Billing Office in West Virginia . This position will ideally work in our Charleston, WV office located at 700 Chappell Rd, but it can also be remote, and we are accepting candidates from all over, not limited to West Virginia!
QUALIFICATIONS / EXPERIENCE REQUIREMENTS
Knowledge of Medicare & Secondary Billing Guidelines
Medicare experience required.
SNF experience preferred.
Previous experience billing various Medicare and Co-insurance companies and understanding the requirements for each payor
Claims appeal / resolution expertise preferred
2 - 4 years advanced education beyond high school, or comparable work experience
Strong verbal and written skills are required in order to interact with insurance companies to resolve unpaid claims via telephone and written correspondence
Professional appearance and mannerisms
Ability to work as part of a team
Computer skills including, but not limited to Microsoft Word, Excel, and Outlook
Knowledge of Medicare DDE, e-Solutions, Point Click Care and Quadax preferred
JOB DUTIES & RESPONSIBILITIES
Verify receipt of monthly triple check forms and audit for accuracy per triple check policy prior to claims submission
Review of Medicare A, Medicare A No Pays / Benefit Exhaust, Medicare B, and Medicare Secondary Payer claims for accuracy and timely submission per Medicare, Commercial, and Medicaid billing guidelines
Submission of Medicare Advantage Copy claims
As Medicare payment occurs, identify and submit billing for secondary claims that do not automatically crossover to secondary insurance
Daily cash posting of Medicare and Secondary payments per Cash Postings policy
Follow-up on unpaid claims and document account within standard billing cycle time frame (Medicare : 16 days after submission, Commercial / Medicaid Coinsurance : 14-21 days after submission)
Monitor for and report Medicare additional development requests (ADR’s) per process guidelines
Identify and submit necessary rebilling for secondary / tertiary claims during follow-up
Conduct account research and analysis
Submission of write offs for uncollectable accounts
Identify and create batches for necessary billing adjustments
Creation and submission of cost Report Bad Debt write offs for states assigned to Medicare CBO, per Medicaid billing guidelines
Accurately prepare and maintain various reports to include : Monthly Cash Report & Shortage Explanation, Triple Check Audit, Credit Balance Report
Interact with facility staff to resolve outstanding issues
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