Medical Billing Specialist, Cash Poster

Job Description: • Responsible for timely and compliant Private Duty billing, authorizations, and reimbursement for designated region • Work directly with revenue cycle director, billing compliance coordinator, agencies, and intermediary to facilitate billing claims • Obtain authorizations as needed • Prepare, audit, and submit claims electronically for appropriate payment • Follow up on outstanding claims and take appropriate action for timely payment • Collect necessary information to prepare claims, coordinating with agencies when appropriate • Bill and submit clean claims electronically and follow up with the Payer • Process, collect, and manage account payments • Monitor claims daily, report totals • Research, correct, and re-submit rejected and denied claims • Follow-up on corrections and report adjustments using revenue cycle management tool • Monitor and maintain assigned accounts • Review billing reports to maintain accurate AR balances • Document follow-ups on claim outstanding balance until final resolution is reached • Keep accurate and orderly records for all billing and accounts receivable activity • Conduct pre-billing audits as assigned • Proactive in identifying potential reimbursement issues while ensuring effective problem resolution • Coordinate with the Agency and Billing Compliance Coordinator on relevant process issues impacting billing • Report any billing issues that develop into trends to immediate supervisor • Answer questions from patients, agency staff, and insurance companies • Interpret and process Explanation of Benefits when needed • Professionally make outbound calls while improving customer relations • Maintain knowledge of current industry standards related to billing and cognizant of new regulations Requirements: • Required Private Duty billing experience • Required Authorization request experience • Preferred, AlayaCare, Waystar, Availity experience • Ability to communicate effectively both verbally and in writing • Excellent customer service skills • Private Duty billing and denial management skills, including VA • Excellent PC skills, Email, Internet Research, Word Processing, Spreadsheets, PDF, and Patient Accounting software systems knowledge (preferably CareVoyant) • Knowledge in accessing the payer portals and reaching out to payers • Claims preparation and audit, including prebill audits for billing compliance • Knowledge of billing regulations and claim submission • Detail-oriented and effective in problem resolution and escalation • Able to organize duties and functions in a highly effective manner to achieve productivity and quality standards • Knowledge of regulations and publications for Private Duty, skilled and unskilled care • Ability to post payments and follow up on discrepancies in payments. Benefits: • Competitive pay • 401k • Health & life insurance • Flexible schedules & career growth opportunities • Continuing education & recognition programs • Supportive, family-like team culture