Home Health Medical Office personnel -Experience using Availity RCM

Job Description

Medical Office Certified Biller/Coder-Fayetteville Ga

Sanzie Healthcare Services Inc is looking for a Certified Medical Biller/Coder. The Biller/Coder position is responsible for billing, collecting, posting and managing account payments. The ideal candidate will be required to investigate claims issues and staying afloat of account receivables. A strong background in medical billing, with the skills necessary to improve our current billing procedures and collecting on patient accounts.

Responsibilities include:

Preparing and submitting claims to various insurance companies electronically

Resolving unpaid claims identified on aged A/R and various other reports, and also for reviewing and responding to all billing-related correspondence

Denial trends are researched and root causes are identified and reported to the Administrator for resolution

Company Payroll

Answering questions from clients, clerical staff and insurance companies

Identifying and resolving insurance/patient billing complaints

Preparing, reviewing and sending patient statements

Ensuring all documents are submitted for proper billing: insurance verification forms, office notes and encounters/superbills

Reporting delinquent accounts to the Administrator & CEO

Performing various collection actions including contacting Clients by phone, correcting and resubmitting claims to third party payers

Participating in educational seminars and staff meetings

Maintaining strictest confidentiality and adhering to all HIPAA guidelines and regulations

Such other tasks as the company may require and/or as needs evolve

Generating, reviewing and transmitting claims

Payment Posting- Mail & ERA's

Provide customer service regarding billing & collection issues, process and review account adjustments, resolve client discrepancies and short payments.

Follow up on submitted claims to ensure payer acceptance.

Review rejected and/or denied claims, make corrections and resubmit clean claim within the required time frame

Review EOB's/ ERA's for any missed opportunities

Follow up on aged accounts receivables through final resolution

Balance bill secondary, tertiary insurance as well as patients

Follow up on payment errors, over-payments, low reimbursements, rejections and denials

Insurance verification

Other duties as assigned based on billing, payment posting, demographic entry, to ensure company goals are met and a team environment is maintained

Maintain the confidentiality of the medical information contained in each record.

Key Requirements:

Ability to research unpaid claims, determine and correct cause, follow up as needed.

Ability to appeal/rebill underpaid or denied claims within payer deadlines.

Knowledge of CPT, HCPCS and ICD-9 codes; familiarity with regional and national payers (including Medicaid, VA, Medicare HMO and Medi-Cal HMO plans).

Should be proficient with MS Office (Word, Excel, Outlook) and have experience working in multiple billing software systems (Availity and MMIS experience a big plus!).

Must have a minimum of 3 years of comprehensive medical billing/collections experience with multiple specialties and a well-rounded understanding of the entire Revenue Cycle process.

Commitment to excellent customer service a must

Excellent written and verbal communication skills

Ability to prioritize and manage multiple responsibilities

HIPAA Compliant

Working Hours/Salary:

Part-time; Compensation to be determined upon review of credentials and experience.

Hours 11:00 am- 5:00 pm Monday - Friday.

Required experience/ education:

3+ years' experience in medical billing, posting charges, insurance verification, payment posting, filing professional claims, ICD-9 & ICD-10

Certification not required, but is a plus

Associate Degree or equivalent

Proficient in billing software Availity, MMIS and Quickbook

Strong analytical skills

Experience in medical terminology, accounts receivable, insurance collections and billing

Experience with HIPAA standards and compliance programs

Knowledge of medical billing/collections practices

Knowledge of computer programs

Ability to operate a computer, basic office equipment and a multi-line telephone system

Knowledge of basic third party operating procedures and practice

Knowledge of Medicare/Commercial Payors and Workers Comp

Skill in answering a telephone in a pleasant and helpful manner

Strong organization, oral/written communication and public relations skills

Ability to maintain effective working relationships with patients, employees and the public

Job Type: Part time

Required education:

Associate degree or equivalent

Certified Biller/Coder

Required experience:

Medical Office: 3 years

Medical Billing: 3 years

EXPERIENCE IN Home Healthcare A PLUS

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