Ltc Medicare Billing Specialist (59561)

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.

Qualifications

• A high school diploma or equivalent.
• At least two (2) 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 Medicare Software and DDE.
• Ability to review and communicate trends and resolutions.