Overview !!$1,000 SIGN ON BONUS AVAILABLE FOR NEW EMPLOYEES!!
This positions is Monday - Friday with typicial hours 8:00am - 4:30pm, with no weekends or Holidays.
Under the supervision of the Home Health/Hospice Manager, performs medical secretarial and claims processing. Coordinates, monitors and actively participates in the processing and follow-up of third party claims for all patients including Home Health, Hospice and Private Duty.
Billing Specialist: Home Health, Hospice, Private Duty and Insurance Screenings
- Utilizes various software applications to perform a wide variety typing/transcription assignments including preparation of certification forms, notices of election, patient medical information. Works with Information Services to maintain software updates.
- Maintains current knowledge of regulations, county, state and federal, including Conditions of Participation, affecting the operation of Home Health and Community Service programs. Communicates changes to the appropriate staff through orientation to these issues.
- Audits medical records of patients for completion according to established standards and policies including assisting with validation.
- Accommodates the public, agency and staff as information resource. Acts as liaison with organizations/ departments that work with the Home Health Division to insure efficient exchange of data.
- Researches, compiles and analyzes data for special projects as assigned.
- Performs layout of specialized forms and computer templates that are utilized in the medical record or are distributed to patients.
- Equipment: Assigns and registers Remote Patient Monitoring units to clients.
- Assembles data for the Hospital CFO/Accountant to complete the Medicare Cost Reports.
- Functions as telephone attendant, activate calling tree and voice mail. Answers and screens calls in a prompt, pleasant and efficient manner.
- Performs other related duties as assigned or requested.
- Provides electronic submission of patient satisfaction data.
- Verification and transmission of Oasis data.
- Proficient in E-Solutions
- Has a strong working knowledge of Home Health Prospective Payment System (PPS), Home Health Resource Groups (HHRG), Hospice Billing requirements and proficient in E-Solution. Develops a thorough understanding and working knowledge of all public and private insurance programs.
- Coordinates, oversees and participates in all aspects of billing for the department. This includes recording charges, computerized processing of claims, downloading remittance advice, electronic transmission and hard-copy billing of claims, internal audit of charge record, reviewing UBO4s and 1500's for accuracy, and correcting/obtaining any additional information that may be required.
- Preparation of patient charges and billing of Home Health/visits and enters into agency and hospital systems. Assists with computer processing of claims, downloading information, electronic transmission, and hard copy billing, as well as performing internal audit of charge record, reviewing UB92's for accuracy, and correcting and obtaining any additional information that maybe required.
- Monitors the status of outstanding and/or delinquent claims for all payers through review and investigation of discrepancies, non-payment, and identifies any special circumstances affecting payment delays. Challenges explanations of benefits filing appeals as necessary and responding to inquires from third party payers for information relative to claims including patient complaints.
- Resolves patient complaints involving charges, explanation of benefits and other business related concerns.
- Receives and processes accounts receivable checks on the Epic/Remote Client systems. Identifies appropriate hospital accounts to ensure accurate application of payments received. Consults with the JRMC Reimbursement Specialist as necessary in analyzing data to achieve balance of accounts between Epic .
- Maintains charge master for Epic with interaction and counsel of the Fiscal Services Manager.
- Works with the Medical Claims Coordinator to review Medicare credit balance accounts for preparation of quarterly reports.
- Responsible for licensure renewal and follow through.
- Assigns and registers Remote Patient Monitoring Units to Clients. .
- Provides assignments and direction to volunteer and Home Health Aides who assist in office related procedures
Associate of Arts or Science preferred. Medical Secretarial Training and/or Billing Specialist preferred. Proficiency in medical terminology.
Three to five years related work experience.
Background check is required for this position.