Medical Claims Specialist
1 week ago
Cassena Care is seeking a skilled Medical Claims Specialist to join our team of professionals.
Responsibilities include:
- Collecting, entering, and processing primary and/or secondary claim information for multiple SNF locations.
- Monitoring verifications and authorizations obtained and ensuring complete service spans are covered.
- Providing business office manager and/or responsible party inquiries on account status and charges.
- Researching and resolving zero payment explanations or benefits and exercising all options to obtain claims payments.
- Timely submission of SNF claims to various insurance companies.
- Preparing and generating clean claims for submission to all payor types, including third-party payors, Medicare, and Medicaid.
- Developing and maintaining working relationships with internal/external providers to ensure billings and collections procedures are current.
- Monthly billing for all Commercial and Managed Care plans.
- Overseeing authorization process to ensure accuracy.
- Creating deposits weekly.
- Posting cash to resident ledgers weekly.
- Following up on all outstanding A/R.
Qualifications:
- High School Diploma/GED or equivalent required; Associates Degree or Medical Billing Certificate preferred.
- Experience in area of billing, denials review, and accounts receivable processes required.
- Medicaid and Managed Care Billing Experience.
We offer a competitive salary, generous PTO package, health/dental benefits, and 401k plan.
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