Home Health Billing Specialist
Billing Specialist Job in Worcester, MA
Job DescriptionJob Description
reports directly to the Reimbursement Supervisor and is responsible for the proper and complete handling of all aged patient accounts for the sole purpose of collecting the very highest possible percentage of every billed account. This position maintains close contact with branch location personnel while constantly and consistently attempting to ensure maximum payment from all payers is received timely. This includes payment for all primary, secondary, tertiary or any other payer for all billed accounts including any and all guarantors for services provided. This is inclusive of claims to commercial, Medicare, Medicaid and private pay accounts.
Essential Job Functions
• Works and collects delinquent A/R accounts
• Documents collection efforts in EMR notes screens to include payer contacts, phone numbers, issues, actions taken, etc.
• Maintains current AR at an acceptable percent.
• Maintains DSO at an acceptable level.
• Achieves cash goal on a quarterly basis.
• Keeps supervisor, and branch location personnel informed of any significant collection payer or processing issues.
• Submits adjustments in an accurate and timely manner.
• Requests Bridge Tickets to correct and update EMR.
• Works with Biller to ensure claims are refiled and/or billed to the second insurance in a timely manner.
• Understands payer specific requirements for submitting claims (i.e. includes CMN's, nursing notes, invoices, etc.).
• Understands and enforces SOX 404 controls
• Reviews and responds to correspondence received from payers.
• Reviews and submits guarantor statements as required. Responds to questions from patients regarding statements.
• Addresses denials in an accurate and timely manner.
• Completes document request forms and forwards to location as required.
• Provides exceptional customer service.
• Evaluates data, reports, feedback, observations and other information in determining priorities.
• Uses prior knowledge and industry specific, historical experiences in resolving problems.
• Conducts all assignments as a professional and role model with a sense of urgency.
• Uses professional communication and conflict resolution techniques as required.
• References and reflects upon the Company mission, values, and strategic imperatives in completing and/or assigning all work.
• High school diploma or equivalent.
• Minimum six (6) month prior healthcare insurance experience.
• Computer literate and ability to type, file and maintain audit records.
• Must be able to adhere to confidentiality standards and professional boundaries at all times
• Attention to detail
• Time Management
• Ability to remain calm and professional in stressful situations
• Strong commitment to excellence
• Quick-thinking and astute decision making skills
• Effective problem-solving and conflict resolution
• Excellent organization and communication skills
• Must be able to speak, write, read and understand English
• Occasional lifting, carrying, pushing and pulling of 25 pounds
• Prolonged walking, sitting, standing, bending, kneeling, reaching, twisting
• Must be able to sit and climb stairs
• Must have visual and hearing acuity
• Must have strong sense of smell and touch
• Performs duties in an office environment during agency operating hours
• Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Equal Employment Opportunity and Affirmative Action: Aveanna provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Aveanna complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
CCPA Notice for Job Applicants, Contractors, and Employees Residing in California
As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.
Notice for Job Applicants Residing in California