Accounts Receivable Specialist

Requisition ID
2021-160158
Employment Type
Full Time
Department
Home Health
Hours / Pay Period
80
Shift
Day
Standard Hours
Monday - Friday 8am - 5pm
Facility / Process Level : Name
CHI Mercy Health of Roseburg
Location
OR-ROSEBURG

Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities

Pay Scale: $17.04 – $22.78

 

Shift: Full-Time, Monday - Friday 8:00am - 5:00pm

 

Job Summary:

 

Under the direction of the Home Health Office Supervisor, the Billing Specialist is responsible for accurate and timely preparation and submission of claims and follow up with insurance companies. This position has a broad base knowledge of medical billing procedures, systems and regulatory issues while following Medicare and Medicaid billing practices.

 

Essential Duties:

  • Works directly with insurance companies, health care providers and patients to ensure accurate and timely claim processing and payment. Reviews and appeals unpaid and denied claims. Verifies accurate patient insurance coverage. Prepares and submits claims to various insurance companies either electronically or by paper on a daily basis.
  • Analyzes complex medical records and identifies billable services. Researches and verifies patient information. Accurately completes appropriate billing resulting from analysis.
  • Answers questions from patients, clerical staff and insurance companies in regards to billing issues.
  • Collaborates with Home Health and Hospice Reimbursement Coordinator and Hospice Secretary for back up coverage with initial and ongoing authorization for current Home Health and Hospice patients.
  • Responsible for sending electronic claims for Medicare and Medicaid on daily/biweekly/monthly basis. Responsible for sending claims to all commercial, private insurance, third party and workers compensation. Maintains billing file and records by batch in accordance with Home Health and Hospice established process.
  • Audits and reviews patient charts for accurate billing, return of faxed orders and/or documentation supporting Home Health and Hospice billable services. Makes corrections and resubmits bills as needed.
  • Maintains and monitors billing suspended list.
  • Responsible for billing follow up for any open claims beyond ninety days.
  • Obtains clinical documentation to support services billed.
  • Assists with posting signed returned orders in patient database for Home Health and Hospice.
  • Processes orders and follows-up on any outstanding orders needing a physician’s signature.
  • Acts as a backup for Hospice Secretary as needed.
  • Participates in professional/appropriate hospital and outside in-service activities to keep abreast of technical development as well as to maintain mandated CE credits.

Qualifications

License/Certification:

  • None

Experience:

  • Two (2) years current experience in Medicare/Medicaid Billing required.
  • Experience in Home Health or Hospice billing is strongly preferred.
  • Knowledge of medical terminology required.
  • Must be skilled in office procedures and able to work in a busy office environment.
  • Requires computer, telephone and multiple office machine skills including proficiency using Microsoft Office software.

Education:

  • High school diploma or GED required.

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