Ltc Medicare Billing Specialist (54121)

Job Responsibilities & Duties

• Preparing, reviewing and transmitting electronic claims using our billing software and clearinghouse 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.
• Cook with representatives of insurance companies (including Medicare and Medicaid) to resolve payment discrepancies.
• Possesses strong analytical, time management, organizational, problem solving and decision-making skills.
• Comfortable communicating with all levels of finance, admissions, medical records, and clinical representatives.
• Must have a working knowledge of Medicare, Medicaid and be familiar with commercial insurance billing and their respective plans.
• Provide exceptional customer service.
• Strong computer and billing software skills.

Communication & Cognitive Abilities

• Cooperate with team members to meet goals and complete tasks.
• Exceptional communication and interpersonal skills.
• Must be comfortable working in stressful and deadline driven environment.
• Must be self-motivated, possess good judgement and know when to seek guidance.
• Detail orientation is essential.
• Flexibility to change priorities quickly and have the capacity to handle multiple tasks.
• Willingness to work independently, but also harmoniously as a part of the CBO team, and a larger geographically disbursed team with the BOMs and RAMs.
• Must be knowledgeable of HIPAA compliance and requirements.
• Keep up to date on technology trends, developments and best practices.

Qualifications

• High School diploma or general education degree.
• 2+ years of experience in one or more aspects of the medical billing & 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 are a plus.
• Medicare Software and DDE