Medical Billing Specialist

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* Job Description:

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* Title:

Medical Billing Specialist Job Code: 64305

OH Division:
Senior Living Corporate Status:
Non-Exempt

Reports to:

Lead Medical Billing Specialist Revision date:
April 2019

Supervises: n/a
** PURPOSE
* * According to prescribed policies and procedures of the organization including all applicable state, federal and accreditation regulations and under the general supervision of the Lead Medical Billing Specialist assumes responsibility for performing all general accounting, billings, and bookkeeping functions for the Senior Living Division’s Facilities.
** ESSENTIAL FUNCTIONS
*** Manage accounts receivable for medical billing for the Senior Living Division including, but not limited to:  Part A and B Medicare, Medicaid, Home Health, Hospice, Part B, Outpatient, Managed Care, Insurance, and Co-Insurance Billing.
* Communicates with different insurance carriers for timely payment of our services.
* Prepares and files insurance claims.
* Performs modified “triple check” process to validate third party billing/claims.
* Collects and prepares work papers for audit and cost reports.
* Audits current billing and collection systems to ensure efficiency, accuracy and timeliness.
* Manages the billing process for third party payors as assigned to ensure our systems are created to accurately and timely bill for our services.
* Manages the collection process for third party payors as assigned to ensure our systems are created to accurately and timely collect for our services.
* Creates billing and collection systems for all new payor types. This includes but is not limited to learning about new payor types, create and implement internal systems to bill and collect for these new services, train staff (administrators, nurses, business offices) on the new system, monitor the new systems for efficiency, accuracy and timeliness.
* Reviews all medical records and their correlation to the billing system prior to any external audits by Medicare, Medicaid, Passport, Insurance, etc.
* Creates/modifys payors and maintains reimbursement rates in accounts receivable software.
** NON-ESSENTIAL FUNCTIONS
*** Keeps up to date with all billing regulations as they relate to our medical billing procedures.
* Assists in the set-up of new policies and procedures.
* Assists in the implementation of new billing practices.
* Assists with the transition and software conversion of new acquisitions.
** EXPECTATIONS
* ** Demonstrates and maintains a positive, professional manner, manages time efficiently and effectively, provides leadership as a role model to promote a team approach, collaborates and participates in policy creation and appropriate problem solving methods.
* Must adhere to all policies, procedures, terms and conditions set forth in the National Church Residences’ Employee Information Guide (EIG), the Code of Conduct, as well as any facility handbook, including but not limited to, corporate compliance, drug free workplace, safe work practices, all federal, state, local regulations and laws.
* With respect to Resident Rights, ensures all care is provided with respect and dignity for the residents/clients, their families and the staff. Reports all complaints made by residents/clients and/or families to the appropriate supervisors, reports all allegations of abuse, misappropriation of funds/resident property and/or any other corporate compliance, drug free workplace, safe work practices, all federal, state and local regulations and laws.
* Completes all annual education requirements timely, including but not limited to Compliance, Privacy, Security and HIPAA training and exhibits behavior as set forth by the Code of Conduct in the performance of their duties.
* Performs other duties as assigned.# JOB SPECIFICATION SHEET – Medical Billing Specialist
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* Education:

** Associates degree in Accounting, Finance or Business Administration preferrred.
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* Experience:

** Two to three years-accounting experiences.
** Mental:
** Must have good communication, comprehension, computer and interpersonal skills. Must have the ability to speak, read, write and understand English.

Skills:

Must have working knowledge of Windows, Microsoft Office…