LTC MANAGED CARE BILLING SPECIALIST (70980)

PRIORITY MANAGEMENT • Dallas, TX

7d • Onsite

About The Position

Immediately hiring Long Term Care Managed Care Billing Specialist to join an established team of exceptional and dedicated professionals at our Central Billing Office (CBO). This Managed Care Billing Specialist will be responsible for the timely and accurate submission of claims ensuring those claims result in maximum reimbursement. The position will interact with and provide consistent and exceptional customer service to Business Office Managers (BOMs) and Regional Account Managers (RAMs) while having discussions based upon data used to prevent and/or resolve claim issues. They must ensure compliance in record keeping and honor calendar deadlines to achieve billing and financial close goals. This position requires prompt follow up on open items to ensure full payment received on behalf of the Residents being serve.

Requirements

• High School diploma or general education degree.
• 2+ years of experience in one or more aspects of the medical billing & collections cycle.
• Exceptional problem-solving abilities and attention to detail particularly as it relates to claim investigation, denials, appeals and collections.
• Knowledge of Microsoft Office Suite.
• Must have a working knowledge of Medicare, Medicaid and be familiar with commercial billing and their respective plans.
• Strong computer and billing software skills.
• Must be knowledgeable of HIPAA compliance and requirements.

Nice To Haves

• Knowledge of Texas Medicaid, PCC and/or American Health Utility software packages are a plus.
• Managed Care Insurance Portals Review/Communicate Trends and Resolutions

Responsibilities

• Preparing, reviewing and transmitting electronic claims using our billing software and clearinghouse, and paper claims as necessary.
• Verify insurance coverage as needed to confirm accurate claim submission.
• Identify secondary and tertiary payers as needed.
• Ensure clean claims released to insurers and follow up on unreleased claims within billing cycle timeframes for multiple locations.
• Review payments for accuracy and apply those payments against the related account.
• Coordinate with BOMs to investigate and resolve denied claims and return corrected claims to the appropriate insurer promptly.
• Work with representatives of insurance companies (including Medicare and Medicaid) to resolve payment discrepancies.
• Provide exceptional customer service.
• Keep up to date on technology trends, developments and best practices.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED