Medical Billing Specialist

Description

Position

Description:

This Billing Specialist is an experienced support role with expertise in Home Health Care billing processes, including PDGM, episodic, and institutional claims. The Billing Specialist will have work tasks and responsibilities with accounts receivable (AR) and revenue cycle management, combined with advanced knowledge of electronic billing and claims management systems. This role requires exceptional attention to detail, analytical problem-solving skills, and the ability to ensure accurate and timely claims submission and payment processing.

Performance Responsibilities and Standards:

1. Review and analyze claims for accuracy and completeness, obtain and/or correct any missing or inaccurate information related to Home Health Care (PDGM, Episodic, Institutional Claims)

2. Compile and submit claims/invoices to appropriate payors/clients within the timeframe designated within the department billing schedule.

3. Must have prior experience in AR/Revenue cycle to ensure timely follow up on claims/invoices.

4. Research and work/appeal unpaid claims when appropriate to ensure optimum collections.

5. Post payments timely with 100% accuracy.

6. Knowledge of electronic billing, billing exceptions and EDI software (Waystar) to ensure claims are submitted and followed up timely.

7. Communicate billing, payment and collections issues to Billing Manager on a current basis.

8. Utilize agency IT systems to carry out job requirements.

9. Attend meetings and workshops as required.

10. Required to bill and collect within the payor filing requirements.

11. All other duties as assigned

Requirements

Requirements:

1. Two or more years' experience in the healthcare industry as a medical biller, Home Care preferred.

2. Compliance with agency policies and procedures

3. Strong computer literacy and comfort, ability and desire to advance technically and understand industry standards.

4. Proven analytical and problem-solving skills to identify potential issues and participate in their resolution.

5. Proficiency with computer systems, working knowledge of Microsoft Office, Internet, and various software applications.

6. Demonstrate the ability to work independently and collaboratively with the ability to adapt to shifting priorities, demands, and timelines.

7. Demonstrates discretion in handling confidential and sensitive information

8. Excellent communication skills, verbal and written, and exceptional attention to detail.

Physical Requirements:

1. Ability to sit or stand at a desk 90% of the day. Frequently sitting, standing, walking.

2. Visual/hearing ability sufficient to comprehend written or verbal communication.

3. Ability to express oneself verbally and in writing.

4. Ability to use the telephone and communicate over the phone.

5. Extended periods of computer use.

6. Ability to lift and move objects up to 40 pounds.

7. Bloodborne Pathogens Exposure Category III - Employee who rarely has contact with blood and body fluids.

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit  for more information.

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