Billing Specialist

The Billing Specialist contributes to the billing functions and coordinates and manages the accounts receivable (AR) duties including accurate and timely completion and submission of the billing, collections, and management of the computer information system for billing of Medicare, Medicaid and other third party payers both electronically and on paper.PRIMARY RESPONSIBILITIESAccounts ReceivableAccurately enters patient/client billing data, OASIS, visit charges, fee for service charges, and verifies discharge and admission data.Coordinates, reviews, and analyzes documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing.Coordinates, reviews and analyzes accounts receivable tracking tools and maintains accounts receivable files in order to ensure accurate and timely claim submission and to prevent lost revenue.Ensures patient eligibility is confirmed through insurance companies and the Medicare or Medicaid systems as appropriate, and that the necessary paperwork is accurate and submitted timely to prevent lost revenue.Maintains tracking tools and data to ensure that all necessary information is secured for timely accurate payment. This includes eligibility, insurance verification, authorizations, certification and recertification as well as state required documentation for Medicaid.Ensures that the appropriate payers have been identified and verified. This includes securing and reviewing the Medicare secondary payer questionnaire, verifying required authorizations are in place with the Medicaid MCOs, etc.Assists in the preparation of monthly accounts receivable review reports in order to ensure accuracy and timely processing of claims billed.Alerts appropriate management team members regarding late or missing documents required for billing.Works to rebill and collect old accounts receivable and claims that have been rejected for payment.Alerts the Billing Manager of seriously overdue accounts receivable.Oversee prebilling processes by including, but not limited to, reviewing invoices created to ensure accurate data, clearing and being the direct contact for non-billable partial visits and over-authorizations, and clearing information as necessary from the EVV Aggregator.General GuidelinesAdheres to the agency's Code of Conduct, conducting all business activities in a professional and ethical manner.Interacts with all staff, patients/clients, payers, and other customers in a positive fashion supporting the agency's mission and vision.Complies with the agency's general orientation and to agency policies and procedures including confidentiality and HIPAA guidelines.Maintains the confidentiality of patient/client and agency information at all times.Ensures compliance with local, state and federal laws, and established agency policies and procedures.Participates in staff meetings, department meetings, team meetings, briefings, inservices, committees and other related activities as needed.Job Types: Full-time, Part-timePay: $20.00 - $28.00 per hourBenefits:Dental insuranceFlexible scheduleHealth insurancePaid sick timePaid time offVision insuranceWork from homeSchedule:Monday to FridayAbility to Relocate:Bala-Cynwyd, PA 19004: Relocate before starting work (Required)

Created: 2025-05-22