Complete Staffing Solutions, Inc Hiring for Medical Billing Specialist, 32/hour Job at Lawrence, MA Full Time

Contract

M-F, FT hours 8a-4:30p

Summary/Objective
Responsible for timely submission of home health and hospice billing for multiple third party payers including, but not limited to, Medicare, Medicaid, commercial carriers and self pays. Manages accounts receivables from admission through satisfaction of balance.

Essential Functions

All payer source changes and additional information edited in system as directed by the Accounts Receivable Manager or when identified with other patient accounts staff.

Generate claims immediately as soon as directed by Accounts Receivable Manager. Screen bills for correct rates, claim codes, policy insurance company/HMO names and addresses.

Generate NOA claims and final invoices on a daily basis for Medicare billing.

Screen claim management page for 485’s and VFO’s and for various QA rules and functions and follow up accordingly to avoid timely filing limits.

Review accounts in work queues and prioritize accounts that need inquiry for collection of accounts and to prevent untimely filing. Match against EOB’s.

Bill secondary copay immediately upon receipt of payer source EOB if necessary.

Act immediately on all requests from payer sources for additional information in order to process claims.

Resubmit claims or adjustment forms for unpaid claims when appropriate.

Researches error claims and makes necessary correction for clean claim productions.

Review accounts listed on AR Aging Report over 60 days and prioritize accounts. For Medicare, use FISS to verify inquiries.

Prepare information on all claims over 90 days and report to manager as required.

Telephone insurance companies and HMO’s to discuss status of unpaid, past due claims. Follows up on delinquent accounts according to established policies and procedures.

Submit write-off and/or allowance adjustment requests to manager for approval and processing.

Run FISS generated reports on a weekly basis to check RAP’s and claims that are in a return to provider location and work to release into a payment status for Medicare claims.

Review credit balances for quarterly MCR review.

Verifies Commercial/HMO eligibility in cases where there is an insurance change.

Electronically verifies insurance eligibility to ensure appropriate insurances are billed to avoid the need for re-bills.

Verifies enrollment in other insurances when Medicare is listed as a payor for patient.

Calls on all other third party payers and identifies home care coverage. Makes inquiries of co-payments and deductibles.

Sends certified mail indicating fiscal responsibility to clients with insurances that require co-pays and deductibles.

Maintains insurance screen in system per agency protocol.

Alerts Accounts Receivable Manager of issues concerning questionable coverage or potential non-payment.

Keeps all involved departments informed of verifications on all new admissions.

Keeps all folders with adjustments, resubmissions (if appropriate) and EOB’s orderly and easy to acquire.

Demonstrates knowledge of the CQI process.

Demonstrates a knowledge and understanding of what to report to the supervisor or Director of Quality Improvement when concerns of corporate compliance arise.

Ensures compliance within guidelines set forth by regulatory agencies (JCAHO, DPH, ERISA etc.) and demonstrates compliance with Home Health Foundation policies and procedures.

Maintains professionalism with colleagues, peers and customers. Puts forth a positive agency image at all times.

Participates in all mandatory in-services.

Demonstrates a knowledge and understanding of what to report to the CEO or Chief Compliance Officer when concerns of corporate compliance arise.

Ensures compliance within guidelines set forth by regulatory agencies (DPH, ERISA etc.) and demonstrates compliance with Home Health Foundation policies and procedures.

Practices confidentiality principles set by the agency and federal HIPAA/HITECH guidelines.

Completes other duties as assigned..

Position Type/Expected Hours of Work & Travel
This is a full-time position, and days and hours of work are Monday through Friday, 8:00 a.m. through 4:30 p.m.

Required Education and Experience

High school graduate or equivalent-Associates degree in business or related field a plus.

Current knowledge of rules and regulations governing third party payers and working knowledge of various billing tasks.

Knowledge of computerized billing and A/R systems and various PC based programs (Excel, MS Word)

Demonstrated excellence in interpersonal skills, and effective oral and written communication skills.

Job Types: Full-time, Contract

Pay: $28.00 – $32.00 per hour

Benefits:

• Health insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Lawrence, MA: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Microsoft Word: 1 year (Preferred)
• Medical Billing: 1 year (Required)

Work Location: One location