Medical Billing Specialist

VITAS Healthcare•Miramar, FL

11h•Onsite

About The Position

Medical Billing Specialist is responsible for the complete and accurate billing and collections of all hospice claims submitted for payment to third-party payers, including, but not limited to, Medicare, Medicaid, Managed Care, commercial carriers, and any other state and federal health care programs. Performs all follow-up duties associated with rebilling, adjustments, corrected claim submissions, and collections of all overdue accounts/claims in accordance with best business practices. Must be able to work on-site at our Corporate Miramar, Florida office, Monday through Friday, 8am- 5pm work schedule. Meets established daily productivity standards. Schedule and download the daily bill job files and processes for transmittal. Research, correct, and re-submit rejected and denied claims. Responsible for timely billing whether by paper or electronic claim in the appropriate claim format. Monitor insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner- knowledge of questions to ask for proper processing. Responsible for identifying problems and solutions or enhancements to resolve billing issues including, but not limited to, billing frequency, required forms, and general billing requirements. Identify problem accounts and escalate as appropriate. Update the patient account record to identify actions taken on the account. Manages clearinghouse and payor accept/reject reports timely while ensuring all claim rejections are resolved within 72 hours of rejection occurrence. Logs repetitive errors or exceptions and reports them to management to ensure the admission record and related systems are properly updated and corrected. Coordinates with collectors and management to become familiar with the changing demands and requirements of payers in each state. Interacts with other areas and departments to troubleshoot and resolve issues that may not have standard documented solutions. Provide support to the Collectors by producing timely, accurate and complete billing documents. Stays abreast of changes in all editing processes as may be required. Acts as a resource for billing information and assists collectors and other staff members in producing any special documentation which may be required. Identify coding or billing problems from EOBs and work to correct the errors in a timely manner. Understands and serves and as subject-matter expert for billing specifications and requirements of assigned payers and states Understand Hospice Notice of Election (NOE) submission timing requirements and exceptions.

Requirements

Three to four years prior experience in a general office environment (accounting or billing experience in a healthcare environment preferred)
Knowledge of insurance billing guidelines including Medicare, Medicaid, and other third party payers
Possess a full understanding of the health care collections and reimbursement process, and an in depth knowledge of the insurance industry
Ability to work on various assignments simultaneously
Strong interpersonal skills within all levels of the organization
Ability to navigate within automated systems and proficiency in Outlook, Word and Excel
Completion of high school or basic education equivalency required

Responsibilities

Complete and accurate billing and collections of all hospice claims submitted for payment to third-party payers
Perform follow-up duties associated with rebilling, adjustments, corrected claim submissions, and collections of all overdue accounts/claims
Meet established daily productivity standards
Schedule and download the daily bill job files and processes for transmittal
Research, correct, and re-submit rejected and denied claims
Responsible for timely billing whether by paper or electronic claim in the appropriate claim format
Monitor insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner
Identify problems and solutions or enhancements to resolve billing issues
Identify problem accounts and escalate as appropriate
Update the patient account record to identify actions taken on the account
Manage clearinghouse and payor accept/reject reports timely while ensuring all claim rejections are resolved within 72 hours of rejection occurrence
Log repetitive errors or exceptions and reports them to management
Coordinate with collectors and management to become familiar with the changing demands and requirements of payers in each state
Interact with other areas and departments to troubleshoot and resolve issues
Provide support to the Collectors by producing timely, accurate and complete billing documents
Stay abreast of changes in all editing processes as may be required
Act as a resource for billing information and assists collectors and other staff members in producing any special documentation which may be required
Identify coding or billing problems from EOBs and work to correct the errors in a timely manner
Understand and serve and as subject-matter expert for billing specifications and requirements of assigned payers and states
Understand Hospice Notice of Election (NOE) submission timing requirements and exceptions