Gadzoom Health is a growing Medical Directorship Group dedicated to providing exceptional care to patients in skilled nursing facilities. We are committed to delivering high quality services and improving the health outcomes of our patients. Our team consists of skilled professionals who are passionate about making a difference in the lives of others.
We are seeking an enthusiastic and experienced Billing and Insurance Verification Specialist to support accurate verification and billing workflows for our medical directorship services across skilled nursing facilities. This role focuses on administrative support, patient communication, client relations, and establishing a strong start to all revenue cycle processes.
This position reports to the Director of Revenue Cycle Management, contributing directly to compliance and efficient revenue cycle workflows that uphold our mission of elevated care. This role will work closely with SNF partners to obtain and maintain precise patient information and perform essential billing duties that support clean claims and timely reimbursement.
This position is a full-time, in office role with the potential to transition to a hybrid schedule at the discretion of the manager.
Key Responsibilities:
Insurance Verification & Eligibility:
- Verify patient insurance eligibility, benefits, and coverage details
- Obtain and update patient demographics and coverage details with clients and facilities
- Provide patient outreach for missing information or clarification
- Communicate with payors to validate coverage and resolve discrepancies
Compliance and Data Integrity:
- Perform routine audits of insurance and patient data for accuracy and completeness
- Maintain compliance with payor guidelines, HIPAA regulations, and internal policies
- Support reconciliation efforts and assist in resolving discrepancies
Cross-functional Collaboration
- Partner with SNF clients, facilities, and internal teams to ensure accurate and timely information flow
- Communicate with providers, administrative teams, and billing team on documentation needs
- Contribute to process improvements to enhance accuracy and reduce claim rejections
Helpful Knowledge, Skills and Abilities
- 3 to 5+ years of front end medical billing or revenue cycle experience preferred
- In depth knowledge of medical billing workflows, including claim submission and denial management
- Strong understanding of insurance requirements, eligibility verification, and authorization processes
- Familiarity with medical terminology, HIPAA privacy regulations, and EHR systems
- Experience with multi state or multi facility billing workflows
- Knowledge of payor requirements across Medicare, Medicaid, and commercial insurance
- Ability to work independently and assume assigned responsibilities
- Proficiency in Microsoft applications including Excel, Outlook, and Word
- Strong verbal and written communication skills
- Ability to manage confidential information with professionalism and discretion
- Highly organized with strong attention to detail
Benefits:
- Comprehensive benefits package including health insurance, dental, vision, and more
- Health savings account
- Paid time off plus six company paid holidays
- Opportunities for professional development and career advancement within a growing healthcare organization
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