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Medical Biller/Collections Specialist in West Chester, PA at Benchmark Senior Living

Date Posted: 4/26/2019

Job Snapshot

Job Description

Wellington at Hershey's Mill, West Chester, PA, is seeking a Medical Biller/Collections Specialist. In this role you will be responsible for the capture, billing, adjustment, and collection of all charges generated by the Wellington Terrace Skilled Nursing Facility, and outpatient medical charges.

 

Responsibilities and Competencies

  • Proficiency with Microsoft Windows software, including Excel, Word, and Outlook.
  • Proficiency with the operation and maintenance of the ECS Billing.
  • Proficiency with the claims management software system.
  • Distribution of Self-Pay invoices to residents to insure timely collections.
  • Medicare, Managed Care and Long Term Care (LTC) experience required
  • In-depth knowledge of Resource Utilization Groups, Common Procedure Terminology, International Classification of Diseases Version 10, and HCPCS coding.
  • Experience with Medicare, and Medicare & Commercial HMO/PPO billing guidelines and rules, insurance reimbursement methods, and the claims appeal process.
  • Knowledge of and ability to follow insurance carrier guidelines in order to ensure that Electronic Data Interface and paper claims are submitted with proper documentation, consent form, referral and/or authorization as needed.
  • Ability to review & interpret insurance Explanation of Benefits & Electronic Remittance Advices to determine & identify reasons for claim denial, and when appropriate, appeal course of action for resolution.
  • Able to identify potential problem trends such as incorrect coding or down coding, and carrier non-payment trends.
  • Create and maintain a positive and disciplined work environment with residents, their families, clinical staff, and management.
  • Ability to communicate effectively both written and verbal.
  • Must consistently demonstrate professional behavior.
  • Performs other duties as assigned.

 

 

Job Requirements

QUALIFICATIONS

A minimum of three years’ experience in a medical environment (hospital, skilled nursing facility, physician office).

Certified Revenue Cycle Specialized preferred.

Associate’s Degree required.

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