Medicare Corporate Biller →

Optalis Healthcare; Novi (MI); On-site; USD 42,000 - 65,000; Full time

Job summary

Optalis Healthcare is seeking a Corporate Biller to accurately bill payers and assure timely payments for services provided. The role includes follow-up on unpaid claims, auditing accounts, and assisting the Corporate Billing Manager as needed.

The ideal candidate has accounting/billing experience, familiarity with Availity, and knowledge of managed care, Medicare, Medicaid, and third-party insurers. Strong organizational and communication skills are essential.

Qualifications

• Education or experience with accounting functions; degree preferred.
• Specialized training in Medicare and Insurance billing.
• At least two years long term care billing experience.
• Working knowledge of third-party insurers.
• Working knowledge of Department of Human Services.
• Experience with collection calls and follow up documentation.
• Strong organizational skills and ability to multitask.
• Interpersonal skills and effective communication with staff, residents, and families.
• Proficient with technology including MS Outlook, Word, Excel and billing software.

Responsibilities

• Billing and collections of assigned payers.
• Understand terms of managed care/hospice contracts and bill accordingly.
• Review admissions weekly to ensure proper data in accounting systems.
• Post cash accurately.
• Daily follow up on receivables and respond to denials promptly.
• Maintain knowledge of billing for all commercial insurances, Medicaid, Medicare, and managed plans.
• Bill coinsurance and deductibles; adjust balances in the system.
• Explain Explanations of Benefits, co-pays and deductibles.
• Conduct month-end billing data entry and processes.
• Inservice office staff as needed.
• Manage time to meet deadlines.
• Support accounts receivable collections and pursue delinquent accounts.
• Prepare external reports for third parties as assigned.
• Participate in in-service training and facility meetings.
• Learn emergency and disaster procedures; perform other duties as assigned.

Skills

Billing and collections

Data entry

Interpersonal skills

Multitasking

Microsoft Excel

Availity familiarity

Education

Accounting/Finance degree preferred

Tools

Availity

Job description

The Corporate Biller accurately bills payers to assure timely payments of services provided, follows up on unpaid claims and audits accounts as necessary to resolve balances. Additionally, the Corporate Biller will provide assistance to the Corporate Billing Manager as requested.

Essential Functions and Responsibilities

To perform this job successfully, an individual must be able to perform each key function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the key functions.

Responsibility

The billing coordinator will be responsible for maintaining the following:

• Responsible for billing and collections of assigned payers.
• Understand the terms of managed care/hospice (BCBS 5 th Level and Medicaid) contracts and bill in accordance with these terms.
• Review admissions weekly to assure data is properly inputted in the accounting system for proper billing.
• Accurately posts all cash.
• Follows up daily on receivables outstanding and responds to requests for information and denials in a timely manner.
• Maintains up to date knowledge of how to bill ALL commercial insurances, managed care, Medicare PPO, HMO, advantage plans, auto claims, worker’s compensation claims, Medicaid HMO and managed Medicaid plans.
• Accurately bills coinsurance and copay amounts; adjust account balances in accounting system appropriately.
• Addresses and is able to explain Explanations of Benefits, co-pays and deductibles.
• Conducts data entry for month end billing. Completes month end processes timely.
• Inservice business office staff as needed.
• Effectively manages time to meet deadlines.
• Direct involvement in accounts receivable collections process, including responsibility for pursuit of delinquent accounts.
• Responsibility for completing external reports for third parties as assigned.
• Participation in relevant in-service training sessions.
• Attendance and participation in relevant facility meetings
• Develop a working knowledge of all emergency and disaster procedures of the facility.
• Willingness to perform other duties as assigned, including various clerical duties as they are necessary.

Qualifications

• Education or experience with accounting functions, including accounts payable, billing, accounts receivable, collections, and bank reconciliations. A degree is preferred, but not required with significant relevant experience.
• Specialized training in Medicare and Insurance billing preferred
• At least two years long term care billing experience
• Working knowledge of third-party insurers
• Working knowledge of the department of Human Services
• Understands and has worked with Availity and similar programs
• Understands process of Medicaid Applications
• Experience with collection calls and follow up documentation.
• Strong organizational skills, including managing the outcomes of others, and the ability to effectively multi task.
• Possesses strong interpersonal skills, including communication with supervisors, other staff and managers in the facility, vendors, and effective communication with residents and family members.
• Ability to effectively manage outcomes of this position as well as the outcomes of others in an environment of accountability.
• Effective user of technology, including personal computer and software applications in job functions. Examples include Microsoft Outlook, Email, Word, Excel, Internet, and use of billing and accounting software.

EEO is the Law