Medical Billing Specialist

Job Description

Job Description

Gadzoom Health is a growing Medical Directorship Group dedicated to providing exceptional care to patients in skilled nursing facilities. Our team consists of skilled professionals who are passionate about making a difference in the lives of others and improving patient health outcomes.

We are actively seeking experienced Medical Billing Specialists to support accurate and efficient billing and revenue cycle operations for our services provided across skilled nursing facilities in multiple states. This position will assist with claim submission, payment posting, account follow up, and resolving billing issues and discrepancies.

Billing Specialists will report to the Director of Revenue Cycle Management and work closely with our providers, insurance payers, patients, and partnered skilled nursing facility communities. The ideal candidate has prior hands on medical billing or revenue cycle experience, learns new systems and processes quickly, and can work independently while maintaining a high level of accuracy.

This is a full time, in office position with the potential to transition to a hybrid schedule at the manager's discretion.

Key Responsibilities:

• Review patient demographic, insurance, and service information for accuracy and completeness
• Prepare and submit claims in accordance with payer, contractual, and regulatory requirements
• Review claim status and follow up on unpaid, rejected, or denied claims
• Research and resolve billing discrepancies, claim edits, and reimbursement issues
• Assist with account reconciliation and identify outstanding balances requiring follow up
• Maintain organized and accurate billing records within internal systems
• Contribute to process improvements that increase accuracy, improve efficiency, and reduce claim rejections and denials
• Provide clear and professional communication regarding coverage and patient financial responsibility

The responsibilities listed provide a general overview of the position and are not intended to be comprehensive. Duties may be added, removed, or modified based on department needs.

Qualifications:

This position is best suited for a candidate with established medical billing or revenue cycle experience. It is not currently intended as an entry level opportunity.

• Working knowledge of medical billing processes, including charge entry, claim submission, payment posting, claim follow up, and denial resolution
• Knowledge of Medicare and Medicaid requirements
• Experience working with payer requirements across multiple states. Familiarity with plans in Utah, Nevada, Texas, and Washington a plus
• Ability to learn new systems and processes quickly. Advanced MD, Gehrimed, Availity, Noridian, Prism, UHC a plus
• Ability to navigate multiple payer portals and computer systems efficiently
• Experience working with skilled nursing facilities or other post acute care settings

Benefits at Gadzoom Health:

• Comprehensive benefits package including medical, dental, and vision insurance
• Six company paid holidays
• Paid time off
• Opportunities for professional development and career advancement reimbursement with manager approval

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