Ltc Managed Care Billing Specialist (70980)

Job Responsibilities & Duties

• Preparing, reviewing and transmitting electronic claims using our billing software and clearinghouse, and paper claims as necessary.
• Verify insurance coverage as needed to confirm accurate claim submission.
• IDentify secondary and tertiary payers as needed.
• Ensure clean claims released to insurers and follow up on unreleased claims within billing cycle timeframes for multiple locations.
• Review payments for accuracy and apply those payments against the related account.
• CooOrdinate with BOMs to investigate and resolve denied claims and return corrected claims to the appropriate insurer promptly.
• Work with representatives of insurance companies (including Medicare and Medicaid) to resolve payment discrepancies.

Qualifications

• A high school diploma or equivalent.
• Two or more years of experience in one or more aspects of the medical billing and collections cycle.
• Exceptional problem-solving abilities and attention to detail, particularly as it relates to claim investigation, denials, appeals, and collections.
• Knowledge of Microsoft Office Suite.
• Knowledge of Texas Medicaid, PCC, and/or American Health Tech software packages is a plus.
• Experience with Managed Care Insurance Portals.
• Ability to review and communicate trends and resolutions.