Medical Billing Specialist, Cash Poster
• Job Description:
- Responsible for timely and compliant Private Duty billing, authorizations, and reimbursement for designated region
- Work directly with revenue cycle director, billing compliance coordinator, agencies, and intermediary to facilitate billing claims
- Obtain authorizations as needed
- Prepare, audit, and submit claims electronically for appropriate payment
- Follow up on outstanding claims and take appropriate action for timely payment
- Collect necessary information to prepare claims, coordinating with agencies when appropriate
- Bill and submit clean claims electronically and follow up with the Payer
- Process, collect, and manage account payments
- Monitor claims daily, report totals
- Research, correct, and re-submit rejected and denied claims
- Follow-up on corrections and report adjustments using revenue cycle management tool
- Monitor and maintain assigned accounts
- Review billing reports to maintain accurate AR balances
- Document follow-ups on claim outstanding balance until final resolution is reached
- Keep accurate and orderly records for all billing and accounts receivable activity
- Conduct pre-billing audits as assigned
- Proactive in identifying potential reimbursement issues while ensuring effective problem resolution
- Coordinate with the Agency and Billing Compliance Coordinator on relevant process issues impacting billing
- Report any billing issues that develop into trends to immediate supervisor
- Answer questions from patients, agency staff, and insurance companies
- Interpret and process Explanation of Benefits when needed
- Professionally make outbound calls while improving customer relations
- Maintain knowledge of current industry standards related to billing and cognizant of new regulations
- Requirements:
- Required Private Duty billing experience
- Required Authorization request experience
- Preferred, AlayaCare, Waystar, Availity experience
- Ability to communicate effectively both verbally and in writing
- Excellent customer service skills
- Private Duty billing and denial management skills, including VA
- Excellent PC skills, Email, Internet Research, Word Processing, Spreadsheets, PDF, and Patient Accounting software systems knowledge (preferably CareVoyant)
- Knowledge in accessing the payer portals and reaching out to payers
- Claims preparation and audit, including prebill audits for billing compliance
- Knowledge of billing regulations and claim submission
- Detail-oriented and effective in problem resolution and escalation
- Able to organize duties and functions in a highly effective manner to achieve productivity and quality standards
- Knowledge of regulations and publications for Private Duty, skilled and unskilled care
- Ability to post payments and follow up on discrepancies in payments.
- Benefits:
- Competitive pay
- 401k
- Health & life insurance
- Flexible schedules & career growth opportunities
- Continuing education & recognition programs
- Supportive, family-like team culture
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