BILLING / ACCOUNTS RECEIVABLES SPECIALIST
DUTIES
Manage the Agency’s Medicare coding, billing, and receivable collections.
RESPONSIBILITIES
Assigns diagnostic and procedural codes consistent with ICD-10-CM and HCPCS guidelines.
Knowledge of CMS coding guidelines, as well as Medicare and Medicaid regulations. Requires the ability to read and interpret medical terminology and apply coding skills utilizing knowledge of anatomy, physiology, and disease processes.
Review complete chart including progress notes, consultations, and hospital discharge reports and flag definitive risk-adjustment diagnoses.
Process accounts payable; according to Agency policy; post receivable to appropriate accounts. Provider monthly logs of billables and receivables.
Supervise and/or bills accounts payable, and third-party billing.
Process Medicare and commercial insurance claims. Also assists in billing in HHA and process all HHA claims.
Confirm all HHA Claims have been exported in a timely fashion.
Performs duties in accordance with the Agency mission ensuring the highest quality and efficiency in processing. Ensures accuracy in processing and posting.
Ensure effective communication occurs between We C.A.R.E. vendors and the billing department.
Build customize report using billing reports combined with receivable reports to reflect both the billing & receivable aspects of the business.
Assist in preparation of entry forms for general ledger.
Supervise, and coordinate, credit, and collection to include completion of all necessary paperwork and data entry.
Manage credit and collection activities on past due accounts; participate in all collection activities of problem accounts.
Supervise the completion of all required insurance, Medicare, and Medicaid forms, in a timely manner. Supervise and follow up on receiving signed service agreements.
Review and analyze all financial reports with the Administrator, COO & CFO.
Ability to stay current on Medicare Risk Adjustment education and CMS updates.
Take care of any necessary payroll and billing adjustments.
Ensure the correct data entry of patient information and payroll and billing information into the system.
JOB CONDITIONS
Position is stressful in terms of meeting deadlines.
It is primarily a desk job, which involves sitting, standing, stooping, and walking, as well as an inordinate amount of telephone communication.
Travel is required, by car or airplane to local, out-of-town, or state seminars, conferences, or meetings.
It requires minimal lifting of office records and printouts.
In office setting
One must be able to hear adequately, on the telephone, with no more than an amplifier, and be able to communicate, both verbally, and in writing, in English.
EQUIPMENT OPERATION
The job requires the ability to utilize a PC, calculator, multi-line telephone, and other related office equipment.
COMPANY INFORMATION
Has access to all patient financial accounts, personnel records, and company financial records, which may be discussed with all management staff, including Governing Body.
QUALIFICATIONS
1. Experience as a certified coder with Medicare billing experience. Home Health experience would be a plus. Must have a minimum of 1 year coding experience in Medicare.
2. A strong background in Anatomy, Physiology and Medical Terminology.
3. High school diploma or equivalent with CPC or CPC-A required.
4. Requires the ability to read and interpret medical terminology and apply coding skills utilizing knowledge of anatomy, physiology, and disease processes.
5. Should be a detail oriented with high degree of organizational skills and able to manage accounts payable and receivables.”
6. Must have strong computer skills and expertise in Excel.
7. Ability to maintain strict confidentiality.
8. Must have a criminal background check.
9. Strong interpersonal and communication skills.