LTC MEDICARE BILLING SPECIALIST (59561)

Priority Management; Dallas (TX); On-site; USD 50,000 - 65,000; Full time

Job summary

BridgePointe Financial Services in Dallas, TX is seeking a Medicare Billing Specialist to join the Central Billing Office. The role focuses on timely, accurate submission of claims and maximizing reimbursements, while delivering exceptional service to BOMs and RAMs.

Knowledge of Medicare/Medicaid and commercial plans is essential, along with strong analytical and communication skills. The candidate will work with billing software and clearinghouses, maintain calendar deadlines, and support

Qualifications

• High School diploma or general education degree.
• 2+ years of experience in medical billing and/or collections.
• Knowledge of Medicare/Medicaid and commercial insurance billing.
• Proficient in Microsoft Office; attention to detail and deadlines.

Responsibilities

• Prepare, review and transmit electronic claims using billing software and clearinghouse.
• Verify insurance coverage to confirm accurate submissions.
• Identify secondary/tertiary payers as needed.
• Ensure clean claims and follow up on unreleased claims within cycle timeframes.
• Review payments for accuracy and apply to the related account.
• Investigate and resolve denied claims with BOMs RAMs and insurers.

Skills

Medicare billing

Claims submission

Customer service

HIPAA compliance

Education

High School diploma

Tools

PCC

American Health Tech

Medicare Software

Job description

Job Details

Job Location: BRIDGEPOINTE FINANCIAL SRVICES - DALLAS, TX 75219
Job Shift: Any
Position summary: Immediately hiring Long Term Care Medicare Billing Specialist to join an established team of exceptional and dedicated professionals at our Central Billing Office (CBO).

Job Overview

Job Overview: This Medicare Billing Specialist will be responsible for the timely and accurate submission of claims ensuring those claims result in maximum reimbursement. The position will interact with and provide consistent and exceptional customer service to Business Office Managers (BOMs) and Regional Account Managers (RAMs) while having discussions based upon data used to prevent and/or resolve claim issues. They must ensure compliance in record keeping and honor calendar deadlines to achieve billing and financial close goals. This position requires prompt follow up on open items to ensure full payment received on behalf of the Residents being serve.

Job Responsibilities & Duties:

• Preparing, reviewing and transmitting electronic claims using our billing software and clearinghouse as necessary.
• Verify insurance coverage as needed to confirm accurate claim submission.
• Identify secondary and tertiary payers as needed.
• Ensure clean claims released to insurers and follow up on unreleased claims within billing cycle timeframes for multiple locations.
• Review payments for accuracy and apply those payments against the related account.
• Coordinate with BOMs to investigate and resolve denied claims and return corrected claims to the appropriate insurer promptly.
• Work with representatives of insurance companies (including Medicare and Medicaid) to resolve payment discrepancies.
• Possesses strong analytical, time management, organizational, problem solving and decision-making skills.
• Comfortable communicating with all levels of finance, admissions, medical records, and clinical representatives.
• Must have a working knowledge of Medicare, Medicaid and be familiar with commercial insurance billing and their respective plans.
• Provide exceptional customer service.
• Strong computer and billing software skills.

Communication & Cognitive Abilities:

• Cooperate with team members to meet goals and complete tasks.
• Exceptional communication and interpersonal skills.
• Must be comfortable working in stressful and deadline driven environment.
• Must be self-motivated, possess good judgement and know when to seek guidance.
• Detail orientation is essential.
• Flexibility to change priorities quickly and have the capacity to handle multiple tasks.
• Willingness to work independently, but also harmoniously as a part of the CBO team, and a larger geographically disbursed team with the BOMs and RAMs.
• Must be knowledgeable of HIPAA compliance and requirements.
• Keep up to date on technology trends, developments and best practices.

QualificationsQualifications:

• High School diploma or general education degree.
• 2+ years of experience in one or more aspects of the medical billing & collections cycle.
• Exceptional problem-solving abilities and attention to detail particularly as it relates to claim investigation, denials, appeals and collections.
• Knowledge of Microsoft Office Suite.
• Knowledge of Texas Medicaid, PCC and/or American Health Tech software packages are a plus.
• Medicare Software and DDE
• Review/Communicate Trends and Resolutions