Home Health Medical Office personnel - using Availity RCM, MMIS, QuickBooks

Payroll/Billing — Fayetteville, GA

Sanzie Healthcare Services Inc is looking for an In-home care Billing and Payroll Accounting Clerk. The Biller/Payroll Accounting Clerk position is responsible for billing, collecting, posting and managing account payments. The ideal candidate will be required to investigate claims issues and stay afloat of account receivables. A strong background in medical billing, with the skills necessary to improve our current billing procedures and collecting on patient accounts.

• Understand and adhere to established SHCS policies and procedures.
• Assist with recruiting, associate hiring, orientations, in-services, disciplinary actions, etc.
• Perform payroll duties including verifying timesheets and/or telephony processing. Computer input of timesheet/telephone changes for payroll processing.
• Preparing and submitting claims to various insurance companies electronically.
• Enter new employee data into the payroll and process payroll.
• Resolve unpaid claims identified on aged A/R and various other reports, and also review and respond to all billing-related correspondence.
• Denial trends are researched and root causes are identified and reported to the Administrator for resolution.
• Company payroll.
• Answer and triage calls from caregivers, clients, insurance companies, and prospects.
• Identify and resolve insurance/patient billing complaints.
• Assist in recruiting on various job boards.
• Send MIF, CCNF, and call VA regarding any expired Prior Authorizations.
• Prepare, review, and send patient statements.
• Ensure all documents are submitted for proper billing: insurance verification forms, office notes, and encounters/superbills.
• Report delinquent accounts to the Administrator & CEO.
• Perform various collection actions including contacting clients by phone, correcting and resubmitting claims to third-party payers.
• Participate in educational seminars and staff meetings (monthly or weekly).
• Maintain the strictest confidentiality and adhere to all HIPAA guidelines and regulations.
• Perform other tasks the company may require and/or as needs evolve.
• Generate, review, and transmit claims.
• Payment posting – mail & ERA's.
• Provide customer service regarding billing & collection issues, process and review account adjustments, and resolve client discrepancies and short payments.
• Follow up on submitted claims to ensure payer acceptance.
• Review rejected and/or denied claims, make corrections, and resubmit clean claims within the required time frame.
• Review EOBs/ERA's for any missed opportunities.
• Follow up on aged accounts receivables through final resolution.
• Balance bill secondary, and tertiary insurance as well as patients.
• Follow up on payment errors, over-payments, low reimbursements, rejections and denials.
• Insurance verification.
• Other duties as assigned based on billing, payment posting, and demographic entry, to ensure company goals are met and a team environment is maintained.
• Maintain the confidentiality of medical information contained in each record.
• Record, monitor, and process company Quick Books.

• Review the client's pre-authorized units/hours and dates given by Medicaid, VA, private pay, etc. are placed correctly on Axiscare.
• Review and approve timesheets and payroll information of assigned staff – check each employee's timesheet, member form, and progress note to reflect Axiscare.
• Input the correct hours on the Excel and process payroll and timesheets by the company pay period.

• Ability to research unpaid claims, determine and correct cause, and follow up as needed.
• Ability to appeal/rebill underpaid or denied claims within payer deadlines.
• Knowledge of CPT, HCPCS, and ICD‑9 codes; familiarity with regional and national payers (including Medicaid, VA, Medicare HMO and Medi-Cal HMO plans).
• Proficient with MS Office (Word, Excel, Outlook) and have experience working in multiple billing software systems (Availity and MMIS experience a big plus!).
• Minimum of 3 years of comprehensive medical billing/collections experience with multiple specialties and a well-rounded understanding of the entire revenue cycle process.
• Commitment to excellent customer service a must.
• Excellent…