Billing Specialist

This is a fully remote position, open to applicants in Florida.

📋 Description

• Manage third-party billing, claim resolution, and adjudication processes.

• Oversee FFS and PPS billing procedures.

• Conduct census balancing and verify payor information.

• Confirm insurance and Medicaid coverage.

• Utilize knowledge of Dual Coverage, MCR D, and Commercial Plans related to Long Term Care.

• Address customer billing inquiries in a professional and courteous manner.

• Input fees and charges into Framework LTC.

• Generate daily, weekly, and monthly pre-bills and perform account audits.

• Prepare daily, weekly, and monthly reporting documents.

• Create statements and end-of-month summaries.

• Comprehend and engage with residents regarding account balances.

• Adhere to all relevant government regulations, including HIPAA.

• Execute additional responsibilities as assigned by the Billing Manager.

⛳️ Requirements

• Proficient in reading, writing, speaking, and understanding the English language.

• Capable of thriving in a fast-paced work environment.

• Essential computer skills required.

• Basic math and analytical abilities.

• Proficient in Microsoft Word, Excel, and Outlook.

• Strong organizational skills and attention to detail.

• Ability to operate at a moderate pace.

• Dependable and reliable.

• Strong problem-solving skills.

• Willingness to work various shifts and days.

• Capacity to adapt to a constantly evolving environment.

• High School diploma or equivalent is mandatory.

• Two (2) years of pharmacy billing experience is required; experience in long-term care is preferred.

• Familiarity with Framework LTC and general computer knowledge, as well as 10-key number entry, is preferred.

• Knowledge of Sage software is a plus.

• Must be able to sit or stand for seven (7) to ten (10) hours daily.

• Possible requirement to work extended hours as necessary.

• Ability to lift and/or move up to 30 pounds.

🏝️ Benefits

• Paid holidays: 6 days per year.

• 5 sick days annually.

• Up to 10 PTO days each year, with rollover options and milestone bonuses.

• Option to cash out up to 10 PTO hours every quarter.

• Medical, Dental, and Vision insurance available.

• 401(k) plan accessible for part-time and full-time employees.

• Company-paid life insurance provided.

• Short-term and long-term disability insurance coverage.

• Tuition reimbursement opportunities.

• Competitive compensation with annual performance evaluations and merit-based salary increases.

• Opportunities for career advancement.

• Annual on-site voluntary flu vaccinations.

• Employee referral bonus program available.