Job description

Essential Duties and Responsibilities:

Reporting directly to the Revenue Cycle Manager, the Managed Care Billing Specialist is responsible for knowing all aspects of the revenue cycle. The emphasis will be on the timely and efficient ability to review, bill, manage, and deliver collections of Managed Care and Commercial insurance revenue to its rapidly growing organization. This position is responsible for the centralized billing and collections functions related to Managed Care revenue cycle, including understanding debits, credits, contracts, reimbursement methodology, business metrics and performance reports.

• Understands all aspects of revenue cycle (Managed Care billing) and helps or covers for others as needed.
• Reviews charges, patient information and insurance information prior to billing to minimize underpayments, denials and rebilling
• Reviews claims for appropriate use of procedure, modifiers and diagnostic codes to ensure maximum reimbursement.
• To document and contact facility for review of unclean claims.
• Collaborates with local offices to ensure registration, eligibility, charge capture and collections.
• Establishes systems to assure that all charges and payments are imported / entered into the practice management system in timely and accurate fashion.
• Creates systems to minimize and eliminate manual data entry by converting to automated charge capture from the electronic remittance advice (ERA).
• Develops and adheres to company collections policies.
• Reviews daily activity of all facilities. Ascertains that daily bank deposits (checks, virtual credit cards, EFTs) balance to payment activity posted in the practice management systems.
• Maintains relationships with payers, insurance company representatives, local government payer representatives, etc.
• Communicates payment issues to management, including payer, system or escalated account issues

Required Skills and Abilities:

• Expertise in all facets of the revenue cycle
• Knowledge of medical terminology, ICD10/CPT codes and payer requirements
• Knowledge of Explanation of Benefits (EOB)/Electronic Remittance Advice (ERA) interpretation along with the ability to recognize issues that may prohibit payment from payers
• Experience in office based skilled nursing facility medical billing and collections.
• Experience in the following a plus: Skilled nursing, multi-office organizations with centralized billing.
• Experience with PointClickCare (PCC software)
• Ability to partner well with others (revenue cycle team, providers, office managers, payers, consultants, etc.)
• Effective at working cross-functionally in a fast-paced organization
• Proactive and a self-starter
• Strong computer skills, including Microsoft Word, Excel, and Power Point, as well as experience with clearinghouse billing and editors
• Communicates clearly, effectively and confidently within the organization and maintains professional working relationship with employees
• Ability to work special projects and pull various reports as needed
• Able to work in the corporate office and/or remote Monday-Friday
• Education and Experience:
• High School Diploma or equivalent
• Three (3) years’ experience of the revenue cycle and Medicare/Managed Care billing preferred
• Experience in office based medical billing and collections

Physical Requirements:

Employees must be able to meet the physical requirements with or without reasonable accommodation

• Must be able to sit at a desk and working on a computer for a prolonged period of time
• Must be able to operate telephone, fax, and other office equipment
• Must be able to lift up to 10 pounds at times with frequent lifting, carry, bending, and stooping
• Must be able to utilize verbal, sight, and hearing senses to communicate to payors, state/federal agencies, and the interdisciplinary team
• Must be posses the ability to tactfully communicate with irate patients, family members, and state/federal agencies
• The ability to travel out of state when necessary
• Monday to Friday schedule

Job Type: Full-time

Pay: From $25.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• North Palm Beach, FL 33408: Reliably commute or planning to relocate before starting work (Required)

Experience:

• SNF Billing Medicare: 1 year (Required)

Work Location: In person

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