FULLY REMOTE - Billing Specialist

Position Summary: The Billing Specialist is responsible to provide timely verification of Medicare and insurance benefits on all referrals of potential patients and reviews reports to ensure accurate billing.

Essential Duties and Responsibilities include the following: Other duties may be assigned.

· Works with staff to ensure accurate admission information is captured

· -Basic understanding of medical terminology

· -Understand insurance denials.

· -Monitor and trend denials, appeals and resolutions from insurance carriers

· Completes timely verification of Medicare and insurance benefits on referrals identified as potential patients

· Coordinates pre-certifications and insurance verification for all patients

· Bills appropriate payer in accordance with the requirements of the payer being billed

· Conducts timely follow-up on all accounts

· Manages detail authorization information from insurance companies

· Works with CMS system (DDE) to identify the prompt flow of accounts through editing, suspense and RTP status

· Proficient in utilizing a claims management system

· Corrects accounts on-line for faster processing

· Manages cash collections

· Maintains unbilled days at the established corporate goal

· Maintains bad debt at the established corporate goal

· Ensures Credit Balance Report is worked daily and quarterly: refunds patients and reverse contractuals as needed

· Ensures that all charges from the acute facility are correctly and timely entered on the patient’s account

· Compiles and provides accurate reports of monthly, quarterly and annual AR statistics

· Keeps abreast of developments in Medicare, Medicaid, and insurance admission and billing requirements Experience Minimum 2 years hospital billing and collection experience to include Commercial, Managed Care, Medicare and Medicaid across all states

Qualifications: To perform the 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.

Education/Experience:

· 3 years of previous Revenue Cycle Management in a healthcare setting, hospital business process preferred. Understanding of Commercial, Government, Medicare, and all Managed Care plans to be able to identify and articulate errors to management and staff

· Demonstrates competence in leadership skills to develop and implement organizational strategies and opportunities for improving hospital growth

· Effective English communication skills, both written and verbal

· Expert level experience with Microsoft Office Products- ability to create and build spreadsheets and reports in Excel

· Knowledge of medical terminology, CPT codes, and ICD-10 codes preferred. Maintain current knowledge and adhere to appropriate regulatory standards such as Government Required Experience

· Maintain current knowledge and adhere to appropriate regulatory standards such as Government

Language Ability: Ability to read, analyze, and interpret general business periodicals, professional journals, or governmental regulations. Ability to write reports, and business correspondence. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the public.

Computer Skills: Proficiency in computer skills and Microsoft office

Job Type: Full-time

Benefits:
• 401(k)
• 401(k) matching
• AD&D insurance
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid sick time
• Paid time off
• Retirement plan
• Vision insurance
• Work from home

Schedule:
• 8 hour shift
• Monday to Friday

Work Location: Remote

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