Selfhelp Family Home Care, Inc (a CHHA) affiliated to Selfhelp Community Services, Inc, a not-for-profit 501(c) (3) home health care organization is seeking a full-time Senior Billing & Collection Specialist. Our mission is to promote independent living for the elderly and other at risk individuals through a variety of Home Care, social services and innovative programs. The position offers growth potential to the right candidate.
The selected individual will:
Ensure that all patients’ claims submitted to Insurance Plans are in compliance with regulatory requirements and negotiated contracts.
Be able to understand all CHHA billing forms, terminologies and codes relating to Medicare, Medicaid and Insurance Contracts.
Act as a liaison between clinical, various insurance plans and billing department to establish a smooth billing process and to ensure prompt payments from respective insurance plans.
Be able to understand CHHA reimbursement methodologies related to Medicare, Medicaid and Insurance billing.
Make sure that all unpaid / denied patients’ claims are corrected / appealed on a timely manner, to the respective insurance plans for payment.
Generate monthly aging schedules for management’s review and always maintain receivables more current.
Be able to maintain and update billing system as changes occur in coordination with the billing software provider.
Follow-up with insurance companies to resolve unpaid or underpaid claims.
Manage patients’ insurance eligibilities and coordinate the internal communication of any changes with patients’ insurance plans.
Apply insurance payments properly into the respective patient’s account and reconcile the monthly insurance collection in the billing system to the cash log.
Review Managed Care contracts to determine correct reimbursement for each account.
Be able to work as a team to contribute to the achievement of organizational goals and objectives.
Knowledge, Skills And Requirements
The selected candidate will possess:
Medical billing certification.
Ability to supervise a small team of billers.
Excellent communication and interpersonal skills.
Critical thinking skills with the ability to identify issues and propose resolutions across functional teams and departments.
At least two years of recent knowledge and experience with home care industry billing and collection practices and standards with a thorough understanding of billing and appeal process with Managed Care organizations.
Good Excel skills.
Selfhelp greeted the new century with the initiation of a comprehensive organizational planning process that resulted in adoption of...