PD Medical Billing Specialist, Cash Poster
Job Description:
- Collect all the 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 by utilizing revenue cycle management tool.
- Monitor and maintain assigned accounts.
- Review billing reports to maintain accurate AR balances.
- Document all follow-ups completed on the claim outstanding balance until the final resolution is reached.
- Keep accurate and orderly records for all billing and accounts receivable activity.
- 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 any relevant process issue impacting billing to establish a resolution.
- Report any billing issues that develop into trends to the immediate supervisor.
- Answer questions from patients, agency staff, and insurance companies.
- Interpret and process Explanation of Benefits when needed.
- Professionally make outbound calls, while keeping and improving customer relations.
- Maintain knowledge of current industry standards related to billing, cognizant of new regulations that impact billing.
- Prepare and implement any required change accordingly.
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).
- Reviews and maintains reports and records to ensure accuracy.
- 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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