Nursing Home Billing Specialist - Remote

The Carmelite System, Inc.•Holyoke, MA

3d•$27 - $31•Remote

About The Position

The Carmelite System is a multi-state, not-for-profit senior living organization sponsored by the Carmelite Sisters for the Aged & Infirm operating a network of Skilled Nursing Facilities and Assisted Living/Independent Living communities. We are seeking to hire a Nursing Home Billing Specialist - Remote. This corporate level position is fully remote. Current Team members work in Eastern and Central Standard Time. $27 per hour to $31.25 per hour based on skills and experience.

Requirements

High School diploma or equivalent.
2+ years experience in Skilled Nursing Facility (SNF) billing required.
2+ years experience using PCC (Point Click Care) required.
Extensive knowledge of Medicare, Medicaid, managed care networks and insurance carriers required.
Extensive knowledge of accounts receivable functions including CPT and ICD-10 coding required.
Solid understanding of the current Medicare Compliance, OSHA, and HIPAA regulations and medical terminology required.
Strong basic mathematical skills required.

Nice To Haves

Understanding of Medicaid, Medicare, and Third Party Billing preferred.

Responsibilities

Prepare, review, and transmit claims using billing software.
Analyze explanation of benefits forms to review denial codes and make appropriate corrections.
Follow up on balances, unpaid claims, appeals & denials within the set timeframe.
Post payments and adjustments to accounts and maintain backup records.
Maintain patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Ensure proper records handling.
Input ancillary charges into the billing software in accordance with protocol.
File all charge, payment, adjustment batches, refund requests and write off requests in the appropriate format and location (PCC and shared drive).
Prepare and review claims for billing prior to triple check.
Attend and lead monthly triple check reviews.
Follow claims process from submission to clearinghouse and ensure acceptance at payer.
Process refunds to insurance companies in accordance with policy.
Monitor reimbursement from managed care networks and insurance carriers.