Billing Specialist

GENESIS HEALTHCARE SYSTEM

In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an 'owner' of Genesis and keep our patients at the center of everything we do - always.

Position Details:

Work Shift:

Varied Shift (United States of America)

Scheduled Weekly Hours:

40

Department:

Physician Billing Dept

Overview of Position:

Bills accurate information to government and/or commercial payers according to established guidelines and government regulations. Serves as coordinator for GMG billing by performing and directing duties that process bills related to government payors according to governmental regulations. Coordinates and works with other departments, payors, attorneys, patients as appropriate and others as necessary to ensure correct information is billed. Responds to patient inquiries in a responsible, professional and caring manner for quality customer satisfaction.

ESSENTIAL DUTIES

1. Bills accurate information to government and commercial payers according to established guidelines and government regulations.
2. Works with payers as necessary to resolve problems resulting in correct and timely reimbursement.
3. Works rejections/denials and work lists in a timely manner to prevent write-off's.
4. Works with the coding and credentialing department to realize and correct denial patterns and to ensure optimum reimbursement.
5. Reconciles monthly banking logs with Accounting.
6. Reconciles daily office posting to Epic and shares information with appropriate practice managers.
7. Responds to patient inquiries and concerns in a responsible, professional and caring manner for quality customer satisfaction.
8. Demonstrates understanding of reimbursement systems including ICD& CPT required.
9. Plans & coordinates all activities regarding third party billing.
10. Ensures compliance with Medicare and other insurance carrier guidelines related to documentation.
11. Responsible for filing medical claims and follow up on pending and problem claims on a timely basis.
12. Communicates with patients and insurance companies as needed regarding insurance issues.
13. Ensures all electronic claims submissions and electronic reimbursement issues are addressed by working with venders and/or information systems.
14. Data entry of charges with verification of proper ICD and CPT codes – specific knowledge of coding applications.
15. Posts personal and insurance receipts.
16. Performs verification, pre-certification and referrals of scheduled surgeries.
17. Assists as collection coordinator, answer billing questions and set up