PD Medical Billing Specialist, Cash Poster

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

📋 Description

• Gather all essential information to prepare claims, coordinating with agencies as necessary.

• Bill and submit accurate claims electronically, and follow up with the payer.

• Handle, collect, and manage account payments effectively.

• Track claims daily and provide reports on totals.

• Investigate, rectify, and re-submit any rejected or denied claims.

• Follow up on corrections and report adjustments using the revenue cycle management tool.

• Oversee and maintain assigned accounts.

• Review billing reports to ensure accurate accounts receivable balances.

• Document all follow-ups conducted on outstanding claim balances until a final resolution is achieved.

• Maintain accurate and organized records for all billing and accounts receivable activities.

• Conduct pre-billing audits as assigned.

• Be proactive in identifying potential reimbursement issues while ensuring effective problem resolution.

• Collaborate with the Agency and Billing Compliance Coordinator on any relevant process issues affecting billing to find a resolution.

• Report any billing issues that evolve into trends to the immediate supervisor.

• Respond to inquiries from patients, agency staff, and insurance companies.

• Interpret and process Explanation of Benefits when necessary.

• Make outbound calls professionally, while fostering and enhancing customer relations.

• Stay informed about current industry standards related to billing, including new regulations that may impact billing processes.

• Prepare and implement any required changes accordingly.

⛳️ Requirements

• Required experience in Private Duty billing.

• Required experience with authorization requests.

• Preferred experience with AlayaCare, Waystar, and Availity.

• Strong verbal and written communication skills.

• Excellent customer service abilities.

• Proficient in Private Duty billing and denial management skills, including for VA.

• Strong PC skills, including email, internet research, word processing, spreadsheets, PDF, and knowledge of patient accounting software systems (preferably CareVoyant).

• Review and maintain reports and records to ensure accuracy.

• Familiarity with accessing payer portals and contacting payers.

• Experience in claims preparation and auditing, including pre-bill audits for compliance.

• Understanding of billing regulations and claim submission processes.

• Detail-oriented with effective problem resolution and escalation skills.

• Ability to organize tasks and functions efficiently to meet productivity and quality standards.

• Knowledge of regulations and publications for Private Duty, skilled, and unskilled care.

• Capability to post payments and follow up on payment discrepancies.

🏝️ Benefits

• Competitive salary.

• 401k plan.

• Health and life insurance.

• Flexible schedules and opportunities for career advancement.

• Continuing education and recognition programs.

• Supportive, family-oriented team culture.