Medical Claims Specialist
2 days ago
Job Title
The Billing Specialist is responsible for managing all Third Party billing and collections functions. This role ensures timely payments within company guidelines for various payers, including Medicare, Medicaid, Managed Care, Co-insurance companies, and Long Term Care Insurance Companies.
This position offers flexibility in working from home.
Key Responsibilities:- Accumulate information with various departments; post to resident accounts.
- Review charges for accuracy, completeness, consistency, and payers charged.
- Prepare and issue accurate billing statements to the correct payer using electronic systems provided.
- Monitor all submissions on a daily basis to address any denials or requests for additional information (ADRs).
- Follow up on unpaid claims/denials within company standard billing cycle timeframes.
- Document all communications and collection attempts.
- Maintain A/R Aging levels for assigned accounts within company guidelines.
- Notify supervisors of difficult/problem accounts.
- Apply Third Party payments daily.
- Establish good relationships with third-party payers.
- Efficiently conduct inquiries and analysis for resolution of discrepancies.
- Two to Three years of experience processing skilled nursing medical claims with third parties.
- One or more years of experience working in a high-volume, short-term rehab environment.
- Proficiency with Microsoft Office and ability to learn company IT systems.
By joining our team, you will have the opportunity to work with a dynamic organization that values teamwork, creativity, and innovation.
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