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RCM Billing and Claims Specialist

3 months ago

Hicksville, United States Sandata Technologies LLC Full time
Job DescriptionJob Description

Sandata Technologies is the leading supplier of software technology solutions serving home care and I/DD agencies, managed care organizations, and state payer programs throughout the United States. The Sandata solution has been implemented by 15,000 Provider Agencies, 18 State Payers, and 50 MCO Payers to ensure their compliance with changes in regulatory/compliance requirements and ongoing complexities. We make it easier for these organizations to work together and to manage their businesses while also getting paid as quickly as possible.

At Sandata, we are committed to creating a real and measurable Diversity, Equity, and Inclusion initiative. We will create a work culture where we are curious, celebrate, respect, and appreciate our unique diverse stories, and how we've come to where we are. We will do everything possible so that people know that we care about them as an individual and work to build equity in our people, systems, and processes. We are continuing to grow our efforts, and we will grow further together.

This position is remote and the candidate can sit anywhere in the United States. This is not a management position.

A Homecare Billing and AR Specialist is responsible for handling the billing and accounts receivable processes within a homecare or healthcare organization. Their primary duties include managing the billing cycle, posting payments, and overseeing the accounts receivable to ensure timely and accurate payment collection. Additionally, they should have a strong understanding of HHA (Home Health Agency) exchange processes and requirements.

Key responsibilities of a Homecare Billing and AR Specialist may include:

  • Billing Cycle Management: Generating and submitting claims to insurance companies, government programs, and other payers for services provided to patients.
  • Payment Posting: Recording and posting payments received from insurance companies, patients, and other sources to the appropriate patient accounts in the billing system.
  • Accounts Receivable Management: Monitoring and following up on unpaid claims, denials, and outstanding patient balances to ensure timely collection of payments.
  • Insurance Verification: Verifying patient insurance coverage and eligibility to ensure accurate billing and reimbursement.
  • HHA Exchange Knowledge: Understanding the processes and requirements related to exchanging health information with Home Health Agencies, including compliance with regulations and standards.
  • Reconciliation: Performing regular reconciliation of accounts receivable records with payments received to identify and resolve discrepancies.
  • Compliance: Ensuring compliance with relevant healthcare regulations, such as HIPAA, and staying up-to-date with changes in billing and reimbursement guidelines.
  • Communication: Collaborating with other departments, such as clinical staff and administrative teams, to resolve billing and payment issues and improve processes
  • Reporting: Generating reports on billing and accounts receivable performance, including key metrics such as days in accounts receivable and collection rates.

To excel in this role, a Homecare Billing and AR Specialist should have a strong understanding of medical billing practices, insurance billing requirements, and healthcare reimbursement processes. Strong communication and problem-solving skills, attention to detail, and the ability to work effectively in a fast-paced environment are also important for success in this position.

Sandata employees enjoy the following benefits:

  • Medical, dental, and vision coverage
  • Flexible Spending Account for health and dependent care
  • Health Savings Account
  • BenefitsVIP/Health Advocate
  • Company paid Life insurance and STD
  • 401(k) Plan
  • Maternity Leave
  • Parental Leave
  • Aflac STD, LTD, Critical Illness, Hospital, and Accident insurance
  • Employee Assistance Program
  • Tuition reimbursement & paid certification programs
  • In-house product training programs
  • Catalog of training courses for skills development
  • Career Pathing for every department
  • Employee Resource Groups (BIPOC, LGBTQ, Women, Military Veterans)
  • Paid vacation, sick days, and holidays
  • Paid lunch break
  • Employee discounts and company perks
  • Casual work environment
  • Remote work
  • Frequent employee events and fun social clubs

Sandata Technologies is an Equal Opportunity Employer M/F/Disabled/Vet