Medical Billing & Collections Specialist (Quality Assurance)

About Rotech

Rotech Healthcare Inc. is a national leader in providing ventilators, oxygen, sleep apnea treatment, wound care 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. Rotech provides high quality medical products, services and outstanding customer care through hundreds of locations across 45 states. For additional information, visit our company homepage Rotech.com

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Overview and Responsibilities

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.

Essential Duties and 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

Supervisory Responsibilities

• None

Qualifications

Employment is contingent on

• Background investigation (company-wide)
• Drug screen (when applicable for the position)
• Valid driver's license in state of residence with a clean driving record (when applicable for the position)

Education and/or Experience

• 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, Knowledge 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

Physical Demands

• Requires sitting, walking, standing, talking or listening
• Requires close vision to small print on computer and or paperwork

Machines, Equipment and Technical Abilities

• Email transmission and communication
• High data entry speed on a 10-key computer and calculator
• Internet navigation and research
• IMBS Bank Management system
• Microsoft applications including but not limited to Word, Excel, etc.
• Office equipment; fax machine, copier, printer, phone and computer

Work Environment

• Office environment

Rotech Information

Benefits

• 401k
• Medical, Dental and Vision
• Life Insurance and Disability
• Generous Paid Time Off and Paid Holidays
• Bonus and Incentive Opportunities (Non-Exempt and Exempt)
• Mileage reimbursement (when applicable for the position)
• Telephone reimbursement (when applicable for the position)

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Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities. Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, gender identity, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees. Rotech Healthcare Inc. is a DRUG FREE WORKPLACE