Senior Healthcare Claims Specialist

Remote Medical Biller Position

At our organization, we specialize in recruiting and managing high-caliber remote staff for dynamic healthcare facilities. We connect clients with highly qualified professionals offering tailored services to meet unique business needs.

Billing & Collections Specialist responsible for Third Party billing and collections functions for assigned accounts in the revenue cycle. Manage 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 is remote and offers flexibility of working from home.

Job Responsibilities:Billing Responsibilities

• Coordinate 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 professional communications.
• Efficiently conduct inquiries and analysis for resolution of discrepancies.

General Responsibilities

• Adhere to policies and procedures of the business with the highest practical standards.
• Participate in and maintain current status on all training and education required by the business.
• 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 appearance that business standards of quality are not present.
• Comply with all rules and regulations of the business including HIPAA and safety.
• Perform other duties as assigned.

Required Skills and Qualifications

• Two to Three years of experience processing skilled nursing medical claims with third parties including Medicare Managed Care and Insurance Companies 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 business IT systems.

Benefits

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

Work Schedule

US Eastern Standard Time EST Monday to Friday 9 am to 6 pm.

Why this Opportunity?

We embrace the flexibility and convenience of a remote working environment collaborating with an international team contributing to our growing business all from the comfort of your home.

Essential requirements you will need to have some essential tools – a reliable computer 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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