HH, IV Billing Coord, Johnson City, TN

Job Description:

Summary:
This position requires knowledge and experience in all areas of insurance reimbursement from initial referral and admission to billing and collections. Requires an extensive knowledge of Home Health, Hospice, Durable Medical Equipment and Infusion Therapy credentialing and licensing requirements, conditions of participation for Medicare, Medicaid and managed care regulations, and audit and reimbursement practices. Must be able to initiate actions to ensure a positive cash flow for all lines of business for Ballad Home Services. Required functions include, but are not limited to, collection of patient demographic information, insurance verification , precertification of ordered services, diagnostic and procedural code assignment, completion and submittal of billing statements, benefit processing, management of aged receivables, and preparation of reports for review by upper management.
Requires an extensive knowledge of Medicare and collection laws and practices. Must be able to accurately and successfully communicate with all social and educational levels of the population including patients, patient's families, physicians, nurses, insurance company executives, attorneys, HMO and PPO personnel. Demands a high level of professionalism and courtesy at all times toward peers and the general public while supporting the objectives and philosophies home health, hospice, and DME agencies. These statements are intended to describe the general nature and level of work being performed by employee assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
This position may be required to cross train within the agency. Responsibilities in secondary position may require access to medical records and other computer access exceeding routine computer usage. Access to patient information may be necessary to fulfill the requirements of this role; therefore, adherence to Ballad privacy and security policies and practices is a must.

Requirements:
Degree in business preferred, plus a minimum two years experience in the area of reimbursement and coding. Ability to read and interpret documents such as medical records insurance manuals, Medicare rules and regulations, managed care contracts documents, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence and to speak effectively before groups of customers or employees of organization. Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, and apply concepts of basic algebra. Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Must be familiar with medical terminology.
Must be able to abstract medical records and assign correct procedural and diagnostic codes, maintaining compliance with government regulations and Ballad's initiatives. Must possess excellent organizational skills. Takes initiative and demonstrates leadership abilities. Must possess excellent problem-solving skills. Requires extensive use of a PC and familiarity of the Home Health software programs. Occasional usage of Word and Excel is necessary. Knowledge of ACCESS is preferable. Ability to access payor and association web sites to maintain and increase healthcare knowledge base. .

Work Requirements:

Shift: Day
On Call: No
Weekends: No
Travel Required: No Travel

Location:

Home Health & Hospice