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Healthcare Claims Specialist
2 months ago
Asbury Gardens is looking for a dedicated Claims Specialist to manage and oversee the billing and claims process for various Medicare programs. This role is essential in ensuring accurate and timely claims submission and follow-up.
Key Responsibilities:
- Prepare, submit, and monitor claims for Medicare Part A, Part B, and Medicare Managed Care (HMO).
- Coordinate responses to Additional Development Requests (ADRs) from Medicare or other insurance providers.
- Maintain excellent accounts receivable results while providing exceptional customer service.
- Collaborate with on-site personnel to address billing needs and resolve issues.
- Generate monthly reports to assess and fulfill billing requirements.
- Utilize Medicare's cross-over billing and work closely with Healthcare Billing for efficient claim processing.
- Track and submit Benefit Exhaust and No-Pay claims as necessary.
- Handle denial claims and ensure compliance with special requirements.
- Ensure timely submission and monitoring of all resident claims.
- Upload Medicare Part A and B claims to UB Watch for accurate billing data.
- Propose necessary adjustments and write-offs to maintain accurate aging representation.
Qualifications:
- A minimum of 5 years of experience in long-term care billing or a related field is required.
- Strong attention to detail and ability to manage multiple tasks effectively.
- Excellent communication skills and a commitment to providing outstanding service.
Asbury Gardens is an equal opportunity employer, welcoming applicants from diverse backgrounds and experiences.
