Job Title 

Location

Additional Location(s)

Employee Type

Working Hours Per Week

SUMMARY
Support Billing Management to ensure timely and correct claims are filed with all respective payers and intermediaries. Monitor claims for timely processing of payments and rejections and work A/R on a weekly basis.
ESSENTIAL DUTIES AND RESPONSIBILITIES
include the following. Other duties may be assigned as necessary.
• Perform claim audit review for Medicare and PDGM Medicare Commercial
• Work the Medicare/Medicare PDGM Claims Held workflow
• Maintain responsibility for Oasis reports
• Review unbilled reports for Medicare and Non-Medicare on a weekly basis
• Bill Medicare/Non-Medicare claims on a daily basis
• Review pre-post report to verify all visits have a usual and customary rate and contractual adjustment on a bi-weekly basis
• Work Medicare/Non-Medicare claim rejections
• Perform billing note entry on all outstanding accounts over 30 days
• Make insurance calls to check status on outstanding claims
• Process requests for additional information from Insurance Companies
• Answer billing queue calls
• Collect patient payments via the phone
• Work monthly Medicare, Medicare, HMO, and 3rd-party agencies
• Review Monthly SOX report to ensure every account over 30 days has a Billing note
• Cover department when other employees are ill or on vacation
• Duties may vary depending on which insurance team the employee is on
• Comply with Company’s Core Values and Core Competencies
• Perform other duties as assigned by supervisor
QUALIFICATION REQUIREMENTS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• High school education or equivalent
• Minimum of one to three years billing experience (preferred in home health care)
• Proficiency in Microsoft Office Suite
• Knowledge of Esolutions, Waystar, and commercial web portals
• Understanding of Medicare FSSO DDE software
• Strong computer knowledge
• Demonstrated patience, flexibility, and cooperative attitude
• Strong communication skills with other office staff
• Conscientiousness and attention to detail
CERTIFICATES, LICENSES, REGISTRATIONS
Must have and maintain in good standing professional license, certificate, or registration, as applicable.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.
COMMENTS
This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.

NOTICE:

• Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.
• By supplying your phone number, you agree to receive communication via phone or text.
• By submitting your application, you are confirming that you are legally authorized to work in the United States.

Graham Healthcare Group is an Equal Opportunity Employer