
Senior Medical Claims Examiner
2 days ago
Billing Specialist Role Overview:
The Billing Specialist will be responsible for managing the billing and collection processes in a healthcare environment, particularly for skilled nursing facilities with proficiency in using PCC (PointClickCare).
Key Responsibilities Include:
- Billing Management: Manage the billing process for Medicare, Medicaid, and other third-party insurance claims, ensuring timely and accurate submission.
- Claims Processing: Review and process claims in accordance with government regulations and insurance policies.
- Accounts Receivable: Track and manage accounts receivable, ensuring timely follow-ups on outstanding claims and payments.
- Compliance: Ensure all billing practices are in compliance with regulatory standards, including HIPAA and payer-specific guidelines.
- Patient Billing: Generate and distribute patient bills, answer patient billing questions, and work to resolve billing discrepancies.
- Denials & Appeals: Address claim denials and process appeals as necessary, following up with insurance companies to ensure proper payment.
- Collaboration: Work closely with the finance department, medical records team, and clinical staff to gather necessary documentation and ensure billing accuracy.
- Reporting: Prepare regular reports on billing activity, accounts receivable status, and collections for management review.
Requirements:
- Experience: At least 1-3 years of experience in medical billing, specifically in long-term care or skilled nursing facilities.
- Knowledge: Strong understanding of Medicare, Medicaid, and insurance billing processes, regulations, and terminology.
- Technical Skills: Proficiency in billing software, electronic medical records (EMR) systems, and Microsoft Office Suite, and PointClickCare.
- Attention to Detail: High level of accuracy in billing and documentation.
- Communication Skills: Ability to communicate effectively with patients, families, insurance representatives, and staff members.
- Industry Standards Knowledge: Familiarity with ICD-10 and CPT coding systems, as well as experience with SNF-specific billing software (e.g., PointClickCare).
Work Environment:
- Remote Work Opportunities
- Night Shift (EST)
- Weekly Pay
- A Healthy Working Environment
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