Medical Billing & Collections Specialist (Quality Assurance)

Job Description

Job Description

Overview

Join a Leader in Home Healthcare

At Rotech Healthcare Inc ., we’re more than a medical equipment provider—we’re a trusted partner in patient care. As a national leader in ventilators, oxygen therapy, sleep apnea treatment, wound care, diabetic solutions, and other home medical equipment, we empower patients to manage their health from the comfort of home.

With hundreds of locations across 45 states, our team delivers high-quality products, exceptional service, and compassionate support that helps patients live more comfortably, independently, and actively. Whether you're a clinician, technician, or healthcare administrator, your work at Rotech directly improves lives.

Explore more about our mission and services at Rotech.com.

Responsibilities

Summary

We are seeking a dedicated Medical Billing & Collections Quality Assurance Specialist for our Billing Center. In this position you will be responsible for auditing all intake paperwork entered in Rotech’s proprietary Medical Billing System prior to selecting the account to bill.

Essential Job Duties and Responsibilities

(Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.)

• Audits incoming paperwork including new patient setups, existing patients and other documents
• Communicates any form errors to the store or makes necessary corrections in IMBS, based on the information written on the form
• Corrects any errors identified by the Claims Supervisor, enters IMBS audit control number located on “Maintenance Audit Report”, verifies in the system that there is an AOB for each claim, files the “Maintenance Audit Report”, and identifies any claims that will release during the nightly cycle, makes copies of necessary forms, and identifies Cash Sale Delivery tickets
• Ensures appropriate authorizations are included from Case Managers
• Ensures service provided to patients is covered in our contract
• Makes a copy of the original form and sends the original back to the store for corrections; maintains a copy of the form until the original is returned
• Must understand VA/Managed Care requirements when working in the VA/Managed Care Billing Center
• Prints the “Maintenance Audit Report” from the system and verifies that the information in the report is accurate; attaches the audit report to supporting documents; submits the packet to the Claims Supervisor for review prior to entering Audit Control
• Receives all Store Patient Packets from Mail Clerk
• Reviews and audits the forms for accuracy and completeness
• Sorts incoming patient paperwork from store locations
• Verifies all documents located on the Batch-Work Control Sheet were included in the patient packet
• Verifies insurance information to ensure accuracy
• Verifies the accuracy of the information in IMBS compared to information on the required forms
• Works with VA/Managed Care Intake Center to ensure authorization is from the carrier and VA and that the information is accurate
• Performs other duties as assigned

Qualifications

Employment is contingent on

• Background check (company-wide). Results will not be used automatically to disqualify individuals. Instead, the Company will conduct an individualized assessment that considers the duties of the position, the nature and timing of the offense, and any evidence of rehabilitation, in accordance with applicable laws.
• Drug screen ( when applicable for the position )
• Compliance with healthcare facility credentialing process ( when applicable for the position )
• Valid driver’s license in state of residence with a clean driving record (when applicable for the position)

Required Education and/or Experience

• High school diploma or GED equivalent, required

Preferred Education and/or Experience

• Experience with medical billing practices and of billing reimbursement, preferred
• Experience in medical field and administrative record management, preferred
• One year of related work experience, preferred
• Medical terminology, preferred

Skills and Competencies

• Accurately perform simple mathematical calculations
• Effectively communicate in English; both oral and written
• Interpret a variety of communications (verbal, non-verbal, written, listening and visual)
• Maintain confidentiality, discretion and caution when handling sensitive information
• Multi-task along with attention to detail
• Self-motivation, organized, time-management and deductive problem solving skills
• Work independently and as part of a team

Machines, Equipment and Technical Abilities

• Email transmission and communication
• Internet navigation and research
• Microsoft applications; Outlook, Word and Excel
• Office equipment; fax machine, copier, printer, phone and computer and/or tablet

Physical Demands

• Lift and carry office equipment at times
• Requires sitting, walking, standing, talking and listening
• Requires close vision to small print on computer and/or tablet and paperwork