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PD Medical Billing Specialist, Cash Poster

Work from home Full-time role Hiring

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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