Billing and Collections Associate

7 days ago

Pasadena, United States GrandCare Health Services Full time
Job DescriptionJob Description

GrandCare Health Services is a physician-trusted leader in post-surgical rehabilitation delivered in the comfort of patients’ own homes.

We are recognized by the Centers for Medicare and Medicaid Services as a 5-Star agency, placing us in the top 10% nationally. Our experienced clinicians collaborate closely with patients’ physicians to develop a personalized plan of care specific to patient needs.

Our tailored, concierge approach is proven to promote faster healing, reduce stress and anxiety, and get patients moving again. GrandCare employees can be proud to know that their work is meaningful and dramatically changes lives for the better. As a Billing and Collections Associate at Grandcare, here is what you can expect:

Job Summary: The Billing and Collections Associate will be responsible for collections, appeals, and denials as well as claims management. The candidate is required to have experience in commercial and managed care collections. The incumbent will need to possess a positive demeanor, good verbal and written communication skills, and be professional in both appearance and approach. The Collections Associate, working independently, must use their strong interpersonal and persuasive abilities to secure accurate and timely payment from third party payers. They candidate display both assertiveness and compassion in resolving accounts and take the appropriate action to resolve disputes related to covered services. The Collections Specialist both understand the transaction and be able to explain the transaction and expected outcome. This position will be responsible for resolving outstanding insurance balances and compliantly maximizing reimbursement from insurance carriers.

Essential Functions: Unless specifically required by law, rule, regulation, or local ordinance, all job attributes are preferred. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Responsibilities:

  • Assume responsibility for patient billing for Medicare, Insurance, and Private Pay by:
    • Entering patient/client data into the computer accurately and in a timely manner
    • Maintaining billed/unbilled patient logs
    • Maintaining patient status changes regarding billing
    • Submitting claims to government agencies, insurance payers, pharmacies and private payers are issued accurately and in accordance with the appropriate contracts
    • Billing and collecting Medicare/Medicare Advantage claims on a timely basis and compliant out-of-pocket financial responsibilities are billed and collected on a timely basis.
    • Following up on all claims from billing through final resolution (payment errors, denials, appeals etc.)
    • Highlighting and reporting uncollected accounts to management
    • Ensuring insurance billing requirements and reimbursement rates are kept up to date
    • Organizing and maintaining billing mail correspondence & reply on a timely basis
    • Responding to patient and internal requests received via email within 24 hours
    • Uploading Oasis to CMS website when needed
  • Utilize insurance accounts receivable reports, billing system tasks, payer web portals, and other tools to follow-up on outstanding balances
  • Coordinate and responds to requests for further billing information and/or medical records
  • Prepare monthly reports and weekly/daily claim submissions
  • Organize all required paperwork for billing
  • Maintain accurate Medicare and Insurance billing analysis reports (logs)
  • Maintain complete and accurate patient/client billing records
  • Communicate with appropriate supervisors regarding late or missing documents required for billing
  • Perform other specific projects relating to billing and data entry as required

Required Education, Experience & Professional Skills:

Education:

  • High School Diploma or GED required

Experience:

  • One year experience in clerical or administrative work strongly preferred
  • Prior experience working in the home health industry preferred

Skills and Abilities

  • Excellent communications, both written and verbal, organizational, presentation and facilitation skills
  • Self-directed with the ability to work with little supervision
  • Excellent observation skills and multi-tasking skills
  • Flexibility and cooperation in fulfilling role obligation
  • Ability to maintain confidentiality in all aspects of the job
  • Ability to respect/protect the confidentiality of information in patient and employee records
  • Ability and knowledge of how to protect documents in a manner that prevents unauthorized access
  • Basic knowledge and use of computers and use of Microsoft Windows required
  • Basic use of Microsoft Office programs (Word, Excel, Outlook, PowerPoint, etc.)
  • Basic phones operations, phone etiquette, filing, copying, faxing, and scanning

Supervisory Responsibilities: This position does not have any supervisory responsibilities.

Position Type & Expected Work Schedule:

This is a full-time, nonexempt position. Typical days and hours of work are Monday through Friday, 8:30 a.m. to 5 p.m.

Travel:

This position does not require travel.

Work Environment:

This job is primarily performed on site in an office environment. This role routinely uses standard office equipment such as computers, tablets, phones, printers, and copiers.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

This role requires a low level of activity. The successful employee would need to be able to perform the essential functions of a typical office role to fulfill the basic functions of the position with or without accommodation.

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