Medical Billing Specialist – Home Health Southwoods Health is hiring a Medical Billing Specialist for our Home Health division. The successful candidate will be responsible for submitting claims to third-party payers, resolving edits daily within the EMR and clearinghouse, and handling correspondence regarding billing inquiries. Essential Duties: - Resolve edits daily through the EMR or clearinghouse to produce clean claims.
- Verify the accuracy of all insurance information.
- Send original claims along with any necessary supporting documentation.
- Determine the need for supporting documentation required by specific insurance companies or cases, and copy documents for inclusion with claims.
- Submit secondary claims, ensuring that primary payment information is captured.
- Understand and abide by billing compliance regulations.
- Follow up with a Coding Specialist and/or Collection Specialist when necessary to correct claims accurately.
- Answer billing questions in a clear and polite manner.
- Understand patient confidentiality laws and the requirements for releasing information.
- Identify billing errors—such as needed changes in procedures or policies—and report them to a supervisor.
- Forward all complex or problematic questions to the applicable supervisor.
- Ensure all processes at the responsible physician practice maintain compliance with all regulatory agencies.
- Perform insurance authorizations.
- Perform other duties as assigned.
Qualifications: - Training or coursework in business office activities, computer skills, and medical terminology.
- Effective communication skills and the ability to problem-solve.
- Ability to maintain a professional demeanor at all times, with strong ethical and moral principles.
- Preferred: Two or more years of collections or billing experience.
- Preferred: Home Health coding experience (not required).
Schedule: Full-time, Monday–Friday, dayshift.
|