Medical Billing Specialist

3 days ago

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

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 & 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
  • Audits incoming paperwork, including new patient setups, existing patients, and other documents
  • Communicates any form errors to the store or makes necessary corrections in IMBS, based on the information written on the form
  • Corrects any errors identified by the Claims Supervisor, enters IMBS audit control number located on 'Maintenance Audit Report', verifies in the system that there is an AOB for each claim, files the 'Maintenance Audit Report', and identifies any claims that will release during the nightly cycle, makes copies of necessary forms, and identifies Cash Sale Delivery tickets
  • Ensures appropriate authorizations are included from Case Managers
  • Ensures service provided to patients is covered in our contract
  • Makes a copy of the original form and sends the original back to the store for corrections; maintains 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
  • Prints the 'Maintenance Audit Report' from the system and verifies that the information in the report is accurate; attaches the audit report to supporting documents; submits the packet to the Claims Supervisor for review prior to entering Audit Control
  • Receives all Store Patient Packets from Mail Clerk
  • Reviews and audits the forms for accuracy and completeness
  • Sorts incoming patient paperwork from store locations
  • Verifies all documents located on the Batch-Work Control Sheet were included in the patient packet
  • Verifies insurance information to ensure accuracy
  • Verifies the accuracy of the information in IMBS compared to information on the required forms
  • Works with VA/Managed Care Intake Center to ensure authorization is from the carrier and VA and that the information is accurate
  • Performs 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
Work Environment

Office environment

Rotech Information

Benefits include 401k, medical, dental, and vision, life insurance and disability, generous paid time off and paid holidays, employee discount program, employee recognition program, bonus and incentive opportunities, mileage reimbursement (when applicable for the position), and telephone reimbursement (when applicable for the position).

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