Medical Billing/collections & Reimbursement Specialist
Personal Home Health Care - Cleveland, OH

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We are a fast growing Home Health Company here to exceed the expectations of our patients, clients, and their families by providing excellent care and premier service. We are seeking a experienced Medical Billing/Collections Reimbursement Specialist to join our organization. The ideal candidate will have prior experience in Home Health Care Billing. The candidate must have an in-depth understanding of Medicare rules and regulations, as well as Medicaid and Commercial Insurance. This individual will be responsible for assuring the timely verification of benefits, billing and tracking of insurance claims, posting adjustments and denials, in addition to following up with insurance companies and/or recipients to reconcile account balances.
This is a full-time position. We offer competitive salaries and benefits packaging.

Principal Accountabilities
*Reviews accounts receivable reports on a daily basis such as the aged accounts receivable, open item report; and, others by Payer Mix to determine collectability, and process steps payment of the claim(s).
*Daily follow-up with Payers to determine next step in the collectability process, then follow through.
*All aspects of the appeals process with all payers, follows up with secondary/tertiary payers to obtain data crucial to claim payment or resubmissions.
*Advises Financial Controller of contractual allowance issues (allowable rate differences) or discrepancies specific to the payer group.
*Advises Financial Controller of problem accounts that cannot be successfully resolved.
*Conduct account research and analysis.
*Maintain an accurate aging report.
*Identify and execute the necessary rebills and process adjustments.
*Post denials as needed. Interact with Payers to resolve outstanding issues.

*In-depth working knowledge of billing/ collection practices mandatory
*Works well in environment with firm deadlines; results oriented.
*Perform multiple tasks effectively.
*OASIS export.
*Final audit process.
*Able to work both independently and as part of a team.
*Strong analytical skill required.
*Capable of making timely, independent decisions.
*Excellent oral, written and interpersonal communication skills.
*Experience working with medical payers such as Medicare, Medicaid, and Commercial insurances.
*Working knowledge of All Scripts medical billing system.
*Excellent organizational skills.
*Proficiency in Microsoft Office, Word, and Excel.

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