Home Services Billing Representative

Works under the direction of the Home Services Billing Office Manager and within the established organizational and departmental policies and procedures, is responsible for accurate claim submission with payee guidelines, accounts receivable timely follow-up and denial management issues for patient accounts activity. Performs tasks required to ensure the timely and accurate submission of insurance claims to all third party payers and documents billing activity in the patient accounting system, such as: Reviewing electronic orders for additional information not sent in the interface transmission (i.e. handwritten information, attachments, copies of insurance cards) and updating system accordingly; completing and enter demographic information; interpreting and coding demographic information; performing specialized processing for accounts missing information; researching multiple systems for missing information and examining historical data to obtain missing information and retrieve per compliance guidelines; and contacting patient for missing information and updating system with new information accordingly. Accurately enters patient billing data, including supply changes into the information system. Works daily electronic billing file and submits insurance claims to third party payers. Reviews daily edit reports from the hospital and/or clinic billing system and makes necessary corrections to allow electronic submission. Reviews error reports from electronic payers; identifies errors and makes appropriate corrections to ensure accurate claim submission. Monitors claim rejections for trends and issues and reports findings to Billing Manager. Prepares and submits manual insurance claims to third-party payers who do not accept electronic claims or who require special handling. Coordinates medical record requests as needed. Documents billing activity on the patient account. Ensures Home Centric compliance with all state and federal billing regulations and reports suspected compliance issues to the Billing Manager. Works with supervision, management and the patient accounting staff to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department. Attends required training. Monitors for Medicare, Additional Development Requests (ADR) and alerts appropriate management of ADR. Other duties as assigned Education H.S. Diploma - High school diploma or GED equivalent - Required Work Experience Typing speed of 45 WPM preferred and 10-key by touch. - Required 1 Year - Experience in accounting, collections and/or insurance billing - Preferred Computer experience - Preferred Licenses and Certifications Upon Hire Travel Requirements Travel to off-site locations may be required. - Required Skills and Abilities Essential Technical/Motor Skills Demonstrated knowledge of third-party billing procedures. Home Health and Hospice billing software experience.  Knowledge of claims review and analysis. Knowledge of Medicare, Medicaid and HMO contracts. Strong computer skills (MS Word and Excel). Excellent oral and written communication skills. Excellent organization and time management skills, and ability to establish priorities effectively. Ability to read, write and follow directions. Self-directed and capable of working without direct supervision. Dependable in both production and attendance. Communicates clearly and concisely with all customers, uses fax, computer, printer, copier, adding machine, and telephone, good hand and eye coordination, and collating. Interpersonal Skills Communicates appropriately and respectfully with everyone at all times. Maintains good rapport and professional relationship with staff. Be a team player. Demonstrates excellent customer service skills by maintaining friendly, courteous and helpful behaviors with everyone. Ability to work well with others. Essential Physical Requirements Ability to operate equipment on continuous/repetitious basis such as computer, telephone, fax, calculator, and copier. Job requires sitting mostly, walking and standing occasionally. Essential Mental Abilities Analyze and interpret data, comprehend and explain, assess and evaluate, organize and adapt excellent short term and long term memory, ability to perform multiple tasks and follow system policies and procedures. Essential Sensory Requirements Visually assesses reports and computer screens, hear telephone and have conversations, distinguish computer input screens. Exposure to Hazards Limited exposure Other Skills and Abilities