Medical Billing Specialist

1 week ago

Orlando, Florida, United States Rotech Healthcare Full time
About Rotech Healthcare

Rotech Healthcare Inc. is a national leader in providing ventilators, oxygen, sleep apnea treatment, wound care solutions, diabetic solutions, and home medical equipment. We help patients lead a more comfortable and productive life by keeping them engaged in their care and empowering them to manage their health and treatment at home.

Job Summary

We are seeking a dedicated Medical Billing and Collections Quality Assurance Specialist for our Billing Center. In this position, you will be responsible for auditing all intake paperwork entered in Rotech's proprietary Medical Billing System prior to selecting the account to bill.

Key Responsibilities
  • Audit incoming paperwork, including new patient setups, existing patients, and other documents
  • Communicate any form errors to the store or make necessary corrections in IMBS, based on the information written on the form
  • Correct errors identified by the Claims Supervisor, enter IMBS audit control number located on "Maintenance Audit Report", verify in the system that there is an AOB for each claim, file the "Maintenance Audit Report", and identify any claims that will release during the nightly cycle, make copies of necessary forms, and identify Cash Sale Delivery tickets
  • Ensure appropriate authorizations are included from Case Managers
  • Ensure service provided to patients is covered in our contract
  • Make a copy of the original form and send the original back to the store for corrections; maintain a copy of the form until the original is returned
  • Must understand VA/Managed Care requirements when working in the VA/Managed Care Billing Center
  • Print the "Maintenance Audit Report" from the system and verify that the information in the report is accurate; attach the audit report to supporting documents; submit the packet to the Claims Supervisor for review prior to entering Audit Control
  • Receive all Store Patient Packets from Mail Clerk
  • Review and audit the forms for accuracy and completeness
  • Sort incoming patient paperwork from store locations
  • Verify all documents located on the Batch-Work Control Sheet were included in the patient packet
  • Verify insurance information to ensure accuracy
  • Verify the accuracy of the information in IMBS compared to information on the required forms
  • Work with VA/Managed Care Intake Center to ensure authorization is from the carrier and VA and that the information is accurate
  • Perform other duties as assigned
Requirements
  • High school diploma or GED equivalent
  • Experience in medical field and administrative record management
  • Minimum of one year experience in medical authorizations preferred
  • One to three years of related prior work experience in a team-oriented environment
  • Strong customer service background
Skills and Abilities
  • Effectively communicate in English; both oral and written, with physicians, location employees, and patients to ensure questions and concerns are processed in a timely manner
  • Helpful, knowledgeable, and polite while maintaining a positive attitude
  • Interpret a variety of instructions in a variety of communication mediums
  • Knowledge of Durable Medical Equipment (DME) or Home Medical Equipment (HME)
  • Knowledge of federal payer program regulations and guidelines
  • Knowledge of insurance policies and requirements
  • Knowledge of medical billing practices and of billing reimbursement
  • Maintain confidentiality and practice discretion and caution when handling sensitive information
  • Multi-task along with attention to detail
  • Must be able to accurately perform simple mathematical calculations using addition, subtraction, multiplication, and division
  • Self-motivation, organized, time-management, and deductive problem-solving skills
  • Work independently and as part of a team
Physical Demands
  • Requires sitting, walking, standing, talking, or listening
  • Requires close vision to small print on computer and or paperwork
Machines, Equipment, and Technical Abilities
  • Email transmission and communication
  • High data entry speed on a 10-key computer and calculator
  • Internet navigation and research
  • IMBS Bank Management system
  • Microsoft applications, including but not limited to Word, Excel, etc.
  • Office equipment; fax machine, copier, printer, phone, and computer
Work Environment
  • Office environment

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