Medical Billing & Insurance Verification Associate

Responsible for supervising the billing process. Develop, present for approval, and implement billing policies and procedures to best achieve the goals of the organization. Coordinate the day-to-day billing processes and functions. Requires contact with other office personnel, medical staff, clients, and third-party payers.

• Work to achieve performance goals, pursue progress toward individual development plan (IDP) and demonstrate our values and competencies
• Management of the billing and payment cycles accurate and timely for hospice and palliative care services, in accordance with established internal and third-party payer requirements
• Accurately screen insurance eligibility for primary, secondary and tertiary payers
• Monitor charge posting, billing, and collection operations for compliance with established policies, federal, state, and local regulations
• Primary resources for guiding new staff and existing staff on new and existing billing policies and procedures.
• Assist in managing monthly accounts receivable for all payers for each member and take necessary actions relating to delinquent accounts, special adjustments, and/or write-offs. Also track progress and stay in close communication with the members and Director of Billing Support services.
• Prepare and present requested reports on billing and collection activities
• Work in conjunction with Director of Billing Support Services/Compliance officer or designee to assure compliance with applicable industry rules and regulations related to Medicare Part A and B billing and other third-party payers
• Maintain up-to-date expertise and knowledge of healthcare billing laws, rules, regulations, and developments necessary for the organization to make informed business decisions
• Accurately post and reconcile payments and adjustments from all pay sources on a weekly basis.
• Auditing payments to ensure that the amount received meets contractual obligations and rebilling/following up as needed.
• Oversight of the Estate billing and recovery process for all counties served.
• Maintain all financial assistance applications through correspondence, capturing, tracking, posting, and adjusting charges.
• Offer recommendations to the Director of Billing Support Services for any opportunities for improvement around claim coding to reduce returned claims and denials.
• Coordinate, import, and obtain required medications, visit notes, and documentation for claim processing.
• Responsible for maintaining/auditing all fee schedules, facility rates, and wage index.
• EMR file maintenance and mapping for all facility types, CPT, HCPCS codes/rates, formation of super bill, and additional reporting configuration.

• Proficient in MS Office:
  Outlook, Word, Excel, Accounting Systems, and Report Writer Software
• Demonstrate excellent attention to detail and accuracy
• Proven leadership skills
• Demonstrate excellent organization, problem solving and analytical skills
• Demonstrate excellent written, oral, and collaborative communication skills
• Demonstrate excellent interpersonal skills
• Ability to work in a fast-paced environment with accuracy
• Ability to make sound and evaluative judgments
• Ability to work under pressure to meet deadlines
• Ability to take initiative and utilize innovative techniques
• Ability to interact with various departments throughout the organization
• Ability to participate as a team player
• Ability to plan, prioritize and coordinate daily tasks
• Demonstrate excellent knowledge of health care billing procedures and documentation
• Strong knowledge base of ICD-10 diagnostic and CPT procedural coding.

• BS in Accounting Preferred
• 2 years’ experience in billing Part A & B Medicare and private payer, preferred
• Insurance coding certification (preferred)
• Valid driver’s license and proof of automobile insurance

Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, age, protected veteran or disabled status, or genetic information.