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

Payroll/Billing — Fayetteville, GA 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 stay 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 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 timesheets and/or telephony processing. Computer input of timesheet/telephone changes for payroll processing. Preparing and submitting claims to various insurance companies electronically. Enter new employee data into the payroll and process payroll. Resolve unpaid claims identified on aged A/R and various other reports, and also review and respond to all billing-related correspondence. Denial trends are researched and root causes are identified and reported to the Administrator for resolution. Company payroll. Answer and triage calls from caregivers, clients, insurance companies, and prospects. Identify and resolve insurance/patient billing complaints. Assist in recruiting on various job boards. Send MIF, CCNF, and call VA regarding any expired Prior Authorizations. Prepare, review, and send patient statements. Ensure all documents are submitted for proper billing: insurance verification forms, office notes, and encounters/superbills. Report delinquent accounts to the Administrator & CEO. Perform various collection actions including contacting clients by phone, correcting and resubmitting claims to third-party payers. Participate in educational seminars and staff meetings (monthly or weekly). Maintain the strictest confidentiality and adhere to all HIPAA guidelines and regulations. Perform other tasks the company may require and/or as needs evolve. Generate, review, and transmit 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 medical information contained in each record. Record, monitor, and process 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 timesheet, 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). Proficient with MS Office (Word, Excel, Outlook) and have experience working in multiple billing software systems (Availity and MMIS experience a big plus!). 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. #J-18808-Ljbffr