What are the responsibilities and job description for the Medical Billing Specialist position at Rose International?
Required Education :
High School Diploma or GED
Required experience :
3 to 5 years is preferred but not needed.
MUST HAVE COLLECTIONS Experience.
Experience in AR / Collections, Billing / Collections, Medicaid and Medicare Collections background, accounting background.
Mid-level range of experience versus no experience.
The goal is 13 million to 16 million monthly in collections.
Will provide training on the systems used - LVAD Driveline, Dyson, & Patient CoVent - No need to come with experience in these systems.
Good Listening, good communication, fine attention to detail, good telephone skills, data entry skills, good customer service, good time-management skills, good analytical skills, good problem solving skills.
Proficiency with revenue cycle systems, reporting, and data analysis, initiates contact with insurance carries regarding status on claims, maintains accurate and complete collection notes concerning collection activities on all accounts, can work independently, responsible for processing appeals and researching of claims, follow specific payer guidelines for appeal submissions and demonstrates knowledge of government payer’s guidelines.
Preferred qualifications / experience / skills :
Coordinates the insurance verification process and makes sure that the client understands their co-pay responsibility.
Responsible to follow-up as necessary to facilitate the collection of co-pays.
When applicable may gather credit card or other payment processing information from client and enters into system to process payment for account.
Manages the entry of client information into computer system in a timely manner and contact of referral source, customer and / or client to obtain missing information needed to set up client for service.
Ensures that the data is accurate and complete.
Confirms all sales orders in the system and ensures that all required information (e.g. proof of delivery, signed prescription, signed acknowledgement form, etc.) is on file before submitting claim for payment.
Follows up on all missing sales orders and reconciles billing questions on a regular basis until payment status is complete.
Responsible for the timely submission of claims (electronic and paper as needed) to payers; Corrects and resubmits front-end and back-end rejected claims.
Ensures that all cash is posted to the correct account in a timely manner.
Responsible for the timely follow-up and collection of payments due to the organization.
This is accomplished by generating invoices and / or following up with clients and / or payers.
Uses available resources to maintain current regulatory guidelines and reimbursement information to insure that the company is obtaining all appropriate information as required for billing and reimbursement.
Performs other duties / projects as assigned by management including customer service support : processing, resolving and logging customer inquiries.
This position is responsible for, but not limited to. Assures that all phases of processing client information are in compliance with HIPAA, PHI regulatory and related policies and practices; reports any Compliance issues to the Director of Operations. Focused on Collections of patient accounts - patients using LVAD (Left Ventricular Assist Device), filing claims, reviewing EOBs (Explanation of Benefits) from Insurance companies with patient over the phone, taking numerous telephone calls per day that drop into queue, using proper Codes to bill.
Industry : Medical / Healthcare
Estimated Start Date : 03 / 17 / 2025
Location : Gainesville, FL 32607
Only those lawfully authorized to work in the designated country associated with the position will be considered.
Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.
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