Billing and Accounting Specialist

Company: RemX - The Workforce Experts
Location: College Station
Posted on: May 15, 2022

Job Description:

Billing and Accounting Specialist 35k-45k College Station Essential Functions Assist in preparation and submission of claims to insurance companies and clients Daily review of claims submitted to insurance companies or billed to patient AR accounts Work directly with insurance companies, facilities, and clients to ensure invoices are processed and paid in a timely manner Verify insurance coverage for new and existing patients Manage all accounts receivable, 3rd party reimbursements, EOBs, patient payments, returns and credits Produce Accounts-Receivable reports where necessary and train partners on how to access reports and statements Manage inventory-control process and audit wholesaler reports and invoices Maintain confidentiality of patient and organization information per applicable HIPAA laws Report any unethical, suspicious, or otherwise morally questionable procedures to company management Continually audit patient files and maintain corresponding documentation necessary to defend third party audits and maintain payer and company compliance Answer billing calls and questions from patients and partners Secure appropriate medical documentation as required by third party insurance carriers. Follow up with third party insurance carriers and patients on unpaid claims or balances. Review and prepare facility and patient statements monthly, review reimbursement reports, pursue payment from delinquent accounts, manage payment arrangements and collection accounts Post and record insurance and patient payments Ensure all Third-Party payments are properly received via direct deposit. Sign up for direct deposit in place of paper check payments Manage and reconcile 835 payments from payers Research payer regulations and claim guidelines regarding claim payment and denial management criteria to ensure compliant billing practices by utilizing website and associated tools established by payers as applicable. Assist in verification of insurance coverage for pharmacy services prior to services being rendered, if applicable. Re-verify benefit coverage criteria as needed for claims follow up. Ensure accurate and thorough documentation of steps taken to resolve claim issues are recorded in billing software(s). Communicate claim issues to Team Lead and/or Billing Manager on a regular basis. Create a process to collect on Aging and current AR account balances Review and send patient and partner statements monthly Review and run rejection reports and process accordingly Audit daily claims to ensure proper billing for Hospice services provided. Ensure that each hospice partner is set up to be billed for services via NCPDP D.0 Other billing and bookkeeping tasks as assigned by management. May be required to cross train in other areas of the pharmacy. Job Requirements Exceptionally detail-oriented personality, with a focus in excellent customer service 1-3 years of billing experience in a Long-Term Care/Skilled Nursing Facility setting preferred 1-3 years in accounts receivable in a healthcare environment; preferred Knowledge with Medicare A & B, Medicaid, and Coinsurance preferred Experience with FrameworksLTC pharmacy software and/or IPS SuiteRx preferred High level of understanding with Word, Excel, Outlook, cloud-based software, e-fax, etc. Proficiency in verbal communication in English and understanding of written English High School Degree or equivalent (GED

Keywords: RemX - The Workforce Experts, College Station , Billing and Accounting Specialist, Accounting, Auditing , College Station, Texas