Remote Billing and Collections Specialist

At a dynamic and growing healthcare organization, we connect clients with highly qualified professionals, offering tailored services to meet our clients' unique business needs.

The Opportunity:

A Billing & Collections Specialist is responsible for all Third Party billing and collections functions for assigned accounts in the revenue cycle. This individual manages billing processes to secure payments within defined company guidelines for Medicare, Medicaid, Managed Care, Co-insurance companies, and Long Term Care Insurance Companies.

This position offers remote work opportunities, providing flexibility and convenience for individuals seeking to maintain a healthy work-life balance.

Essential Duties and ResponsibilitiesBilling Responsibilities

• Coordinate the accumulation of information with various departments; post to resident accounts.
• Review charges for accuracy, completeness, consistency, and payers charged.
• Prepare and timely 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).
• Coordinate with all departments and submit ADR information within 10 days of receipt of request.

Collections Responsibilities

• 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, taking follow-up action in accordance with established policies and procedures.
• Provide needed supporting documentation to payer upon request in a timely manner.
• Maintain A/R Aging levels for assigned accounts within company guidelines.
• Notify supervisors of difficult/problem accounts; residents unwilling or unable to pay balances.
• Process claim reclassification to private accounts upon approval from management.
• Process bad debts in a timely fashion when claims are determined to be uncollectable. Document all reasons for uncollectability and efforts in the process.

Cash Application

• Apply Third Party payments daily including checks, wire transfers, EFT payments, other bank deposits, cash, and credit card payments. Confirm completeness and accuracy of payment information to the residents' accounts.

Customer Service

• Establish good relationships with all third-party payers with professional communications.
• Efficiently conduct inquiries and analysis for resolution of discrepancies.

General Responsibilities

• Adhere to the policies and procedures of the organization with the highest practical standards.
• Participate in and maintain current status on all training and education required by the organization.
• Communicate effectively with all members of the staff and business partners.
• Provide feedback to others for continuous quality improvement of the entire organization.
• Openly accept feedback from others for the continuous quality improvement of the entire organization.
• Escalate issues when there is an appearance that business standards of quality are not present.
• Comply with all rules and regulations of the organization, including HIPAA and safety.
• Perform other duties as assigned.

Job Requirements/SpecificationsEducation and Experience:Required:

• 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.

Preferred:

• MatrixCare/Answers on Demand and Ability experience is a plus.

Essential Qualifications:

• Strong communication, interpersonal, and organizational skills.
• Detail orientation.
• Ability to manage multiple priorities.
• Discretionary judgment.
• Ability to work independently and as part of a team.

Language Skills

• Ability to read, write, and speak English proficiently.

Service Fee:

Industry standards applicable to the state depend on work experience and level of expertise.

Hours:

US Eastern Standard Time (EST) - Monday to Friday, 9 am to 6 pm

Benefits

We offer the flexibility and convenience of a remote working environment, allowing you to collaborate with an international team while contributing to our growing organization from the comfort of your home.

Requirements

You will need to have some essential tools – a reliable computer and noise-canceling headset, a second monitor for enhanced productivity, and a stable internet connection. You'll also be required to have a backup internet connection, ensuring that you're well-equipped to complete your work seamlessly.

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