Performs general data entry, keying, and bookkeeping tasks for the billing department accounts receivable functions that require a high degree of attention to detail, and the ability to analyze and resolve routine problems.PRIMARY RESPONSIBILITIES
- Confirms patient eligibility for Medicaid reimbursement by submitting a report, by branch, to payers at both the start of the service and weekly.
- Notifies Case Managers and Branch Managers when clients are suspended by the State. Also alerts the Service Coordinator and copies the Payroll Department.
- Keep track of all authorizations and expiration dates of the authorizations. Obtain new authorizations before expiration dates
- Identify an over/under authorizations. Contact Service Coordinators and/or Managed Care Organizations to confirm or correct as needed. Work with Case Managers to adjust the schedule to properly utilize the authorization.
- Identify Managed Care Organization and authorization changes as they are occurring, correct and modify master profiles as necessary.
- Performs accounts receivable:
- Submits claims to payors in accordance with payor requirements and agency policy.
- Receives notices of claim denials, properly track and resolve issues to ensure claim payment
- Maintains complete and accurate accounts receivable records
- Performs troubleshooting for billing error codes. May work with the client's Service Coordinator to identify and resolve issues.
- Maintains accurate billing analysis reports and communicates implications promptly to the appropriate parties.
- Analyzes daily reports from the state and matches the approved payments to the client.
- Alerts the Administrator or Manager regarding late or missing documents required for billing.
- Assists with the collection of receivables by monitoring accounts receivables, resubmitting bills to overdue accounts, and alerting the Administrator regarding seriously overdue accounts.
- Produces reports as needed
- Performs administrative duties such as sorting, scanning, filing, and emailing records.
- Performs other job-related duties as assigned.
- Knowledge and Experience. 1-2 years' experience of data entry, record keeping or similar experience in the healthcare field. Knowledge of Medicaid/ Managed Care Organization (MCO), insurance verification and authorization management. Intermediate to advanced computer skills, including the use of Microsoft Office applications (e.g. Word, Excel) and knowledge of Sandata, HHAeXchange and Waystar (Zirmed) is preferred. Analytic and persistent; able to get to the root of problems.
- Personal accountability. Self-motivated; reliable; strong attention to details; maintains confidentiality; complies with all Company policies and procedures.
- Interpersonal Skills. Demonstrates excellent communication and customer service skills under duress and in a fast pace; ability to function as a positive team member.
- Physical Demands. Ability to sit for long periods of time and use a pc keyboard. Able to deal with stress and conflict appropriately with respect for others. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
Posting ID: 549158012Posted: 2020-02-14