Medical Claims Professional
4 days ago
We are seeking a highly skilled Billing Specialist to join our team. The ideal candidate will have excellent communication and organizational skills, with the ability to manage multiple priorities and work independently.
The Billing Specialist will be responsible for coordinating the accumulation of information from various departments, posting charges to resident accounts, reviewing claims for accuracy and completeness, and preparing and issuing accurate billing statements to payers.
The successful candidate will also be responsible for monitoring all submissions on a daily basis, addressing any denials or requests for additional information (ADRs), and coordinating with all departments to submit ADR information within 10 days of receipt of request.
The Billing Specialist will also follow up on unpaid claims/denials within company standard billing cycle timeframes, determine reasons for denial, correct claims, and re-bill when required. Additionally, they will document all communications and collection attempts, provide needed supporting documentation to payer upon request in a timely manner, and maintain A/R Aging levels for assigned accounts within company guidelines.
Key Responsibilities- Coordinate accumulation of information from various departments and post charges to resident accounts.
- Review claims for accuracy and completeness, and prepare and issue accurate billing statements to payers.
- Monitor all submissions on a daily basis, address any denials or requests for additional information (ADRs), and coordinate with all departments to submit ADR information within 10 days of receipt of request.
- Follow up on unpaid claims/denials within company standard billing cycle timeframes, determine reasons for denial, correct claims, and re-bill when required.
- Document all communications and collection attempts, provide needed supporting documentation to payer upon request in a timely manner, and maintain A/R Aging levels for assigned accounts within company guidelines.
- Two to three years of experience processing skilled nursing medical claims with third parties including Medicare, Managed Care, and Insurance Companies with a track record of successful collections.
- One or more years of experience working in a high-volume, short-term rehab environment.
- Knowledge of billing and related software preferred and/or experience with similar software.
- Proficiency with Microsoft Office and ability to learn company IT systems.
This is a remote opportunity that offers flexibility and convenience, allowing you to work from home while contributing to a growing business. As a member of our team, you will have access to industry-standard tools and technology, as well as ongoing training and development opportunities.
About the RoleThis role requires strong communication, interpersonal, and organizational skills, with the ability to manage multiple priorities and work independently. You will be responsible for coordinating with various departments, communicating with payers, and managing accounts receivable. If you are a detail-oriented individual with excellent problem-solving skills, we encourage you to apply for this exciting opportunity.
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