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