About the Opportunity
Does working for a new Home Health agency sound like the professional challenge you are seeking? Discovery at Home offers significant opportunities for growth and career advancement. Employees are encouraged to take responsibility for their own careers. You'll be working with incredible individuals with boundless creativity.
The Medical Billing Specialist role is responsible for the daily billing audit, filing, and receipt of claims with Medicare, private insurance and private pay parties.
RESPONSIBILITIES:
- The Medical billing specialist is responsible for submitting home health claims to private insurance companies and Medicare, in a timely and accurate manner, as well as in accordance with written contracts.
- The specialist will review the patients bill for accuracy and completeness and obtaining any missing information.
- Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
- Follow up on all unpaid claims within standard billing cycle timeframe.
- Call insurance companies regarding any discrepancy in payments if necessary.
- Performs final claim audits on every claim before submitting.
- Oasis exports, reports, and corrections weekly.
- Researching and appeal all denied claims.
- Answering phones and responding to all medical billing questions.
- Must make necessary follow-ups if payments are not received on time and follow government and commercial insurance rules and regulations and make sure that follow best legal practices for collections.
- Participates in community related functions as necessary.
- Assists with the orientation of new professional staff to familiarize them with Agency policies and procedures.
- Must prepare regular reports that are related to account receivables and other relevant issues.
- Participates interdisciplinary team conferences and represents agency in the community as requested.
- Performs other duties as directed.
- May fill in for the other staff when necessary.
- Understands and adheres to established policies and procedures of agency.
- Participates in Quality Assessment and Performance Improvement activities as assigned.
- Attends all mandatory meetings.
JOB CONDITIONS:
- Position is stressful in terms of meeting deadlines.
- It requires minimal lifting of office records and printouts.
- It is primarily a desk job which essentially involves sitting, standing, stooping and walking, as well as an inordinate amount of telephone communication.
- On occasion, one may be required to bend, stoop, reach and move client weight up to 250 lbs, lift and or carry up to 30 lbs.
- Must be able to read 12 point and larger type.
- The ability to communicate well, both verbally and in writing is required.
EQUIPMENT OPERATION:
The job requires the ability to utilize medical nursing equipment as well as a PC, calculator, multi-line telephone, and other related office equipment.
COMPANY INFORMATION:
Has access to all client medical records and client financial accounts, personnel records and company financial records, which may be discussed with all management staff.
QUALIFICATIONS:
- High school diploma or equivalent.
- One year experience in a certified Home Health Agency.
- Should be a skilled organizer able to manage office files with attention to detail and time management.
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