[Hiring] Nursing Home Billing Specialist @The Carmelite System, Inc.

Role Description

We are seeking to hire a Nursing Home Billing Specialist - Remote. This corporate level position is fully remote. Current Team members work in Eastern and Central Standard Time.

• Prepare, review, and transmit claims using billing software.
• Analyze explanation of benefits forms to review denial codes and make appropriate corrections.
• Follow up on balances, unpaid claims, appeals & denials within the set timeframe.
• Post payments and adjustments to accounts and maintain backup records.
• Maintain patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Ensure proper records handling.
• Input ancillary charges into the billing software in accordance with protocol.
• File all charge, payment, adjustment batches, refund requests and write off requests in the appropriate format and location (PCC and shared drive).
• Prepare and review claims for billing prior to triple check.
• Attend and lead monthly triple check reviews.
• Follow claims process from submission to clearinghouse and ensure acceptance at payer.
• Process refunds to insurance companies in accordance with policy.
• Monitor reimbursement from managed care networks and insurance carriers.

This is a brief overview of job responsibilities and not intended to be all inclusive.

Qualifications

• High School diploma or equivalent.
• 2+ years experience in Skilled Nursing Facility (SNF) billing required.
• 2+ years experience using PCC (Point Click Care) required.
• Extensive knowledge of Medicare, Medicaid, managed care networks and insurance carriers required.
• Extensive knowledge of accounts receivable functions including CPT and ICD-10 coding required.
• Solid understanding of the current Medicare Compliance, OSHA, and HIPAA regulations and medical terminology required.
• Strong basic mathematical skills required.
• Understanding of Medicaid, Medicare, and Third Party Billing preferred.

Benefits

• Competitive Compensation
• Health (Aetna), Dental, Vision, HSA with employer contribution
• Flexible Spending Account
• Fully paid Life and Long-Term Disability insurance
• Benefits available 1st of the month following 30 days
• Supplemental insurances
• Retirement Plan
• Student Loan Forgiveness Guidance
• Employee Assistance Program with Discount Marketplace
• Generous Paid-Time-Off with 11 Holidays