Billing Specialist I - Private Insurance

ABOUT CARECENTRIC
CareCentric is the only provider of total solutions for the home health industry—from industry-leading software to comprehensive business services. With more than 35 years of technology expertise and domain knowledge, CareCentric provides solutions for home health, private duty, hospice, home medical equipment, home pharmacy, long-term care and assisted living providers—allowing its customers to focus on patient care and business growth.

 We are headquartered in Atlanta, GA with 9 offices nationwide. At CareCentric, we believe a high level of quality and service is achieved one way - by bringing together qualified, motivated and resourceful people. Our employees lead the industry in experience and knowledge and we are committed to maintaining that standard each time we seek to grow our team. If you want to join a successful company that cares about its employees, CareCentric is the place for you.







SUMMARY



This position is responsible for handling all billing responsibilities for private insurance payers. In summary duties will include: reviewing daily faxes, report preparation for month end, communication with clients and providers, setting up payment agreements, reviewing aging, submitting claims per regulatory guidelines, and working complex and/or denied claims.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

 

Private Insurance

·  Responsible for review of claims for compliance and completeness.

·  Review daily edit reports for Private Insurance payers.

·  Ensure that all claims are submitted timely according to both governmental and non-governmental regulations. Print, post and submit invoices to clients.

·  Check claims status via the internet.

·  Work complex problems and/or denied claims and resubmit as necessary.

·  Review aged receivable and justifies accounts over 120 days.

·  Process credit adjustments as procedures dictate.

·  Handle all levels of telephone appeals.

·  May speak with providers as needed.

·  Perform other duties as assigned.





QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily without posing a “direct threat” to the health or safety of self or others. The requirements listed below are representative of the knowledge, skill, and/or ability required. The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions with in the work environment described.

 

·  Education/Experience

o  High school diploma.

o  1-2 years' of experience in HME/Medical billing environment.

o  Must possess quick and accurate Alpha/numeric data entry ability.

o  PC skills including experience using MS Office and typing/data entry.

o  Present a positive image that reflects well on the organization.

o  Ability to research information via the internet, as well as through knowledge documents, and industry manuals.

o  Must be possess excellent organizational and analytical/problem solving skills

o  Must have ability to prioritize responsibilities to completion within deadlines.

o  Must be detailed oriented while handing multiple concurrent tasks with minimal supervision.

o  Excellent work ethic and commitment to job responsibilities.

o  Must have ability to interact positively with nursing home staff at all levels of management.

o  Strive to improve skills and achieve goals despite setbacks, obstacles. 

o  Bring energy, enthusiasm, and a positive attitude to the job. 

o  Top-notch interpersonal skills and the ability to interact with all levels of employees, customers, and vendors professionally.

o  Must be a self-starter, with ability to work well as part of a team and independently.

·  Preferred

o  Previous experience with skilled nursing home billing.

o  Certification in Medical Billing or Medical Coding.


WHAT YOU CAN EXPECT FROM US

We recognize that our people are our most valuable asset. We offer a competitive salary, as well as a benefits package that includes matching 401k, medical/dental/vision/life insurance, disability benefits, voluntary benefit packages, confidential employee assistance programs, pre-tax accounts for health and dependent care, paid time off, business casual dress, flexible hours, paid company holidays, and tuition reimbursement.

*CareCentric is an Equal Opportunity Employer who is committed to workforce diversity. Qualified applicants will receive consideration without regard to age, race, color, religion, sex, sexual orientation, disability, or national origin. CareCentric is a drug-free workplace.

All resumes are held in confidence. Only candidates whose profiles closely match requirements will be contacted during this search.