Home Health Biller-Pro Care Home Health

Jasper General Hospital • Bay Springs, MS

7d

About The Position

Essential Duties and Responsibilities: The Medical Billing Specialist is responsible for managing accurate, timely completion and submission of all billing, collections, and accounts receivable functions associated with home health claims. Ensures reimbursement through efficient billing and collections operations and Initiates billing process by submitting NOA. Obtain patient eligibility and authorizations. Verify payor information, insurance, and eligibility prior to admission. Verify Medicare, HMO, and private insurances. Track authorizations from admit to discharge. Processing, monitoring, and collecting of Medicare, Medicaid, and other commercial insurance claims in accordance with payer requirements. Provides oversight and approval of claims audits and processing. Conducts final billing audit and issues assignments to pre-billing team when findings require further documentation. Maintains comprehensive working knowledge of payer contracts and ensures that payers are billed according to contract provisions. Represents and acts on behalf of agency in resolving conflicts with payers. Advises Director in matters of accepting/declining problematic payers. Maintains comprehensive working knowledge of government billing regulations including Medicare and Medicaid regulations and serves as a resource for appropriate agency personnel. Following up on accounts for billing and on overdue accounts for collections via phone calls, re-submissions, and adjustments for billing errors. Verifying accuracy of billing data and revising any errors. Importing/posting payments from all payer types. Timely resolution of all claims including appeals.. Supervises the use of the billing information system and maintains a comprehensive working knowledge of the system including upgrades and enhancements. Establishes and maintains positive working relationships with patients, family members, payers, and referral sources. Protects the confidentiality of patient and agency information Education and/or Work Experience Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Demonstrated knowledge of billing regulations for Medicare, Medicaid and insurance processing, medical terminology and coding. Knowledge of regulatory and accreditation standards for home care specific to the reimbursement area. Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service

Requirements

• Demonstrated knowledge of billing regulations for Medicare, Medicaid and insurance processing, medical terminology and coding.
• Knowledge of regulatory and accreditation standards for home care specific to the reimbursement area.
• Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
• Minimum one (1) year of experience in health care billing and collections, preferably in home care.
• Information system knowledge in the areas of electronic claim submission and data entry/report generation.
• Demonstrated organizational skills, detail orientation, flexibility and ability to work with minimal supervision.

Responsibilities

• Managing accurate, timely completion and submission of all billing, collections, and accounts receivable functions associated with home health claims.
• Ensuring reimbursement through efficient billing and collections operations
• Initiating billing process by submitting NOA.
• Obtaining patient eligibility and authorizations.
• Verifying payor information, insurance, and eligibility prior to admission.
• Verifying Medicare, HMO, and private insurances.
• Tracking authorizations from admit to discharge.
• Processing, monitoring, and collecting of Medicare, Medicaid, and other commercial insurance claims in accordance with payer requirements.
• Providing oversight and approval of claims audits and processing.
• Conducting final billing audit and issues assignments to pre-billing team when findings require further documentation.
• Maintaining comprehensive working knowledge of payer contracts and ensures that payers are billed according to contract provisions.
• Representing and acts on behalf of agency in resolving conflicts with payers.
• Advising Director in matters of accepting/declining problematic payers.
• Maintaining comprehensive working knowledge of government billing regulations including Medicare and Medicaid regulations and serves as a resource for appropriate agency personnel.
• Following up on accounts for billing and on overdue accounts for collections via phone calls, re-submissions, and adjustments for billing errors.
• Verifying accuracy of billing data and revising any errors.
• Importing/posting payments from all payer types.
• Timely resolution of all claims including appeals.
• Supervising the use of the billing information system and maintains a comprehensive working knowledge of the system including upgrades and enhancements.
• Establishing and maintaining positive working relationships with patients, family members, payers, and referral sources.
• Protecting the confidentiality of patient and agency information

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed