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This Billing Specialist is an experienced support role with expertise in Home Health Care billing processes, including PDGM, episodic, and institutional claims. The Billing Specialist will have work tasks and responsibilities with accounts receivable (AR) and revenue cycle management, combined with advanced knowledge of electronic billing and claims management systems. This role requires exceptional attention to detail, analytical problem-solving skills, and the ability to ensure accurate and timely claims submission and payment processing.
Job Responsibility:
Review and analyze claims for accuracy and completeness, obtain and/or correct any missing or inaccurate information related to Home Health Care (PDGM, Episodic, Institutional Claims)
Compile and submit claims/invoices to appropriate payors/clients within the timeframe designated within the department billing schedule
Must have prior experience in AR/Revenue cycle to ensure timely follow up on claims/invoices
Research and work/appeal unpaid claims when appropriate to ensure optimum collections
Post payments timely with 100% accuracy
Knowledge of electronic billing, billing exceptions and EDI software (Waystar) to ensure claims are submitted and followed up timely
Communicate billing, payment and collections issues to Billing Manager on a current basis
Utilize agency IT systems to carry out job requirements
Attend meetings and workshops as required
Required to bill and collect within the payor filing requirements
All other duties as assigned
Requirements:
Two or more years’ experience in the healthcare industry as a medical biller, Home Care preferred
Compliance with agency policies and procedures
Strong computer literacy and comfort, ability and desire to advance technically and understand industry standards
Proven analytical and problem-solving skills to identify potential issues and participate in their resolution
Proficiency with computer systems, working knowledge of Microsoft Office, Internet, and various software applications
Demonstrate the ability to work independently and collaboratively with the ability to adapt to shifting priorities, demands, and timelines
Demonstrates discretion in handling confidential and sensitive information
Excellent communication skills, verbal and written, and exceptional attention to detail
Ability to sit or stand at a desk 90% of the day. Frequently sitting, standing, walking
Visual/hearing ability sufficient to comprehend written or verbal communication
Ability to express oneself verbally and in writing
Ability to use the telephone and communicate over the phone
Extended periods of computer use
Ability to lift and move objects up to 40 pounds
Bloodborne Pathogens Exposure Category III - Employee who rarely has contact with blood and body fluids
What we offer:
medical, vision, dental, and life and disability insurance