- Communicate with clients to address day-to-day information requests and resolve lower-level billing-related issues promptly.
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Handle escalated billing responsibilities, including co-insurance, Medicare Part B, therapy filings, and claims for multiple facilities.
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Ensure claims compliance with Medicare, Medicaid, and private insurance guidelines while maintaining high accuracy in coding and submissions.
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Provide detailed and reliable reports on billing activity.
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Act as a Team lead for certain operational tasks, such as monitoring billing performance metrics and assisting with budget management for assigned facilities.
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Mentor and support less experienced team members, providing guidance and training on billing practices and policies.
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Identify and escalate performance or operational issues to the appropriate leadership for resolution.
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Perform additional duties as assigned to meet departmental and client needs.
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5–10 years of billing experience, with a focus on long-term care facilities or healthcare settings preferred.
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Advanced knowledge of billing processes, claims management, and payer requirements for Medicare, Medicaid, and private insurance.
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Strong organizational skills with the ability to manage multiple priorities and meet deadlines.
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Exceptional verbal and written communication skills for interacting with clients and team members at all levels.
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Detail-oriented with a high level of accuracy in billing processes and reporting.
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Analytical and problem-solving abilities to address a variety of billing scenarios.
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Demonstrated ability to handle confidential and sensitive information professionally.
Required Skills and Competencies:
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Comprehensive understanding of insurance industries, managed care programs, and government payer guidelines.
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Proficiency in billing software and tools for tracking claims and generating reports.
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Knowledge of HIPAA regulations and best practices for managing client data securely.
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Ability to identify inefficiencies and suggest improvements to enhance operational workflows.