Home Health Medical Office personnel -Experience using Availity RCM, MMIS, QuickBooks

Home Health Medical Office Personnel

Sanzie Healthcare Services Inc is looking for an In-home care Billing and Payroll Accounting Clerk. The Biller/Payroll Accounting Clerk position is responsible for billing, collecting, posting and managing account payments. The ideal candidate will be required to investigate claims issues and staying afloat of account receivables. A strong background in medical billing, with the skills necessary to improve our current billing procedures and collecting on patient accounts.

Responsibilities include:

• Understand and adhere to established SHCS policies and Procedures
• Assist with recruiting, associate hiring, orientations, in-services, disciplinary actions, etc.
• Perform payroll duties including verifying time sheets and/or Telephony processing. Computer input of timesheet/Telephone changes for payroll processing.
• Preparing and submitting claims to various insurance companies electronically
• Enters new employee data into the payroll and processes payroll
• Resolving unpaid claims identified on aged A/R and various other reports, and also reviewing and responding to all billing-related correspondence
• Denial trends are researched and root causes are identified and reported to the Administrator for resolution
• Company Payroll
• Answering and triaging calls from caregivers, clients, insurance companies, and prospects
• Identifying and resolving insurance/patient billing complaints
• Assisting in recruiting on various job boards
• Sending MIF, CCNF, and calling VA regarding any expired Prior Authorizations
• Preparing, reviewing, and sending patient statements
• Ensuring all documents are submitted for proper billing: insurance verification forms, office notes, and encounters/superbills
• Reporting delinquent accounts to the Administrator & CEO
• Performing various collection actions including contacting Clients by phone, correcting and resubmitting claims to third-party payers
• Participating in educational seminars and staff meetings (monthly or weekly)
• Maintaining the strictest confidentiality and adhering to all HIPAA guidelines and regulations
• Such other tasks as the company may require and/or as needs evolve
• Generating, reviewing, and transmitting claims
• Payment Posting- Mail & ERA's
• Provide customer service regarding billing & collection issues, process and review account adjustments, and resolve client discrepancies and short payments.
• Follow up on submitted claims to ensure payer acceptance.
• Review rejected and/or denied claims, make corrections, and resubmit clean claims within the required time frame
• Review EOBs/ ERA's for any missed opportunities
• Follow up on aged accounts receivables through final resolution
• Balance bill secondary, and tertiary insurance as well as patients
• Follow up on payment errors, over-payments, low reimbursements, rejections and denials
• Insurance verification
• Other duties as assigned based on billing, payment posting, and demographic entry, to ensure company goals are met and a team environment is maintained
• Maintain the confidentiality of the medical information contained in each record.
• Recording, monitoring, and processing Company QuickBooks.

Reviewing timesheets

• Review the client's Pre authorized units/hours and dates given by Medicaid, VA, Private pay, etc. are placed correctly on Axiscare.
• Review and approve timesheets and payroll information of assigned staff -Check each employee's Timesheets, member form, and Progress note to reflect Axiscare.
• Input the correct hours on the Excel and process payroll and timesheets by the company pay period.

Key Requirements:

• Ability to research unpaid claims, determine and correct cause, and follow up as needed.
• Ability to appeal/rebill underpaid or denied claims within payer deadlines.
• Knowledge of CPT, HCPCS, and ICD-9 codes; familiarity with regional and national payers (including Medicaid, VA, Medicare HMO and Medi-Cal HMO plans).
• Should be proficient with MS Office (Word, Excel, Outlook) and have experience working in multiple billing software systems (Availity and MMIS experience a big plus!).
• Must have a minimum of 3 years of comprehensive medical billing/collections experience with multiple specialties and a well-rounded understanding of the entire Revenue Cycle process.
• Commitment to excellent customer service a must
• Excellent written and verbal communication skills
• Ability to prioritize and manage multiple responsibilities
• HIPAA Compliant

Working Hours/Salary:

Part-time; Compensation to be determined upon review of credentials and experience.

Hours 9.00 am- 6:00 pm Monday - Friday.

Required experience/education:

• 3+ years' experience in medical billing, posting charges, insurance verification, payment posting, filing professional claims, & ICD-10
• Certification not required, but is a plus
• Associate Degree or equivalent
• Proficient in billing software Availity and MMIS software
• Strong analytical skills
• Experience in medical terminology, accounts receivable, insurance collections and billing
• Experience with HIPAA standards and compliance programs
• Knowledge of medical billing/collections practices
• Knowledge of computer programs
• Ability to operate a computer, basic office equipment and a multi-line telephone system
• Knowledge of basic third party operating procedures and practice
• Knowledge of Medicare/Commercial Payors and Workers Comp
• Skill in answering a telephone in a pleasant and helpful manner
• Strong organization, oral/written communication and public relations skills
• Ability to maintain effective working relationships with patients, employees and the public

Job Type: Full-time

Required education:

• Associate degree or equivalent
• Certified Biller and Payroll Clerk

Required experience:

• In home care billing experience : 2 years
• Medical Billing: 2 years
• Payroll Experience: 2 years