General Duties and Essential Functions:

• Global responsibility to oversee the accounts receivable process for customers and partners.
• Understanding of Account Receivable and Collections process.
• Good knowledge of Outlook, Word, Excel, and basic accounting software.
• Able to master billing software programs: Net Health, Alinea, and Peachtree.
• Maintains and ensures payer accuracy in all accounts and ledgers to support accurate and efficient billing process.
• Works in collaboration with facilities, Regional Directors, and therapists to produce accurate invoices, claims, and statements.

Job Description Billing Specialist GRA.docx (01/23)

• Good understanding of insurance payers: Medicare, Medicaid, Medicare Advantage plans, Commercial, Workers Compensation, and liability insurance, etc.
• Follow professional standards and meet requirements of local, state, and federal rules and regulations. Keep abreast of changing rules and regulations of Government, State, and commercial payers.
• Performs tasks during the patient intake cycle including but not limited to: insurance benefits and verification, authorization and re-authorizations, obtaining of consent for treatment.
• Assists in the facility invoicing process including the end of month process of gathering logs and generating billing exports on the first of the month and generating invoices on the 15th of the month for the skilled nursing facilities.
• Generates and posts facility payments in invoicing software.
• Generates claims and statements, post payments, and do follow-up for Direct Bill (outpatient) therapy services in RCM software to various payors including Medicare, Medicare Advantage, Medicaid, private insurance carriers, and private pay.
• Serves as a resource for partners (facility staff) and therapy staff to resolve problems with regards to invoicing/statement billing for therapy services.
• Assists with insurance contracting and therapist credentialing as needed.
• Responsible for working the collection module follow-up regularly and timely. Identify overdue and undue paid accounts that require follow-up before timely filing limits have been exceeded. Re-submit claims to insurance payers and work with patients to get statements paid. Keep Revenue Cycle Manager informed of any accounts that are at risk for non-payment. Nothing over 90 days old is standard. Maintain aging percentage goals given by Revenue Cycle Manager.
• Works with other members of the billing to team to ensure the billing operations meet financial and productivity goals of Greenfield Rehabilitation Agency.
• Completes bad debt write off form according to procedure providing proper supporting notes and documentation.
• Other duties as assigned.

Qualifications:

• At least 18 years of age.
• High School Diploma or equivalent.
• Advanced training on billing strongly preferred.