Medical Billing & Collections Specialist

JOB TITLE: Medical Billing & Collections Specialist
LOCATION: 2061 Collier Parkway, Land O Lakes, FL 34639
HOURS: Hybrid

POSITION SUMMARY:

Reporting to the Revenue Cycle Manager, the Medical Billing & Collections Specialist is responsible for managing accurate, timely completion and submission of multiple third party payers including, but not limited to, Medicare, Medicaid, commercial carriers and self pays as well as collections and accounts receivable functions respectively.

EDUCATION AND QUALIFICATIONS:

• Two-to-four years of experience in health care billing and collections preferred.
• High school diploma or GED required. Associates degree preferred.
• Billing information systems knowledge, KanTime preferred.
• Working knowledge of home health, hospice and physician billing.
• Knowledge of Microsoft Excel.
• Knowledge of governmental regulations and billing guidelines.
• Demonstrates good communication skills.
• Demonstrated capability to accurately manage detailed information.
• Able to deal tactfully with patients, family members, referral sources and payers.
• Demonstrates autonomy, organization, assertiveness, flexibility and cooperation in performing job responsibilities.

ESSENTIAL JOB RESPONSIBILITIES:

• Ensures reimbursement through efficient, accurate and timely billing process for effective accounts receivable management.
• Work pre-billing report for assigned payers in preparation for month end close.
• Generates claims for submission to payers in accordance with established schedule.
• Utilizes technology to manage clearinghouse and payor accept/reject submissions and reports timely.
• Responsible for accurate posting of cash payments and preparation of cash balancing process.
• Reviews A/R reports and researches unpaid claims. Takes necessary steps to collect unpaid claims and address credit balances. Provide reports to the Patients Account Manager as needed.
• Process correspondence and telephone calls from all payors regarding claims.
• Complete appeals on underpaid claims to the payer.
• Identify, prepare and submit patient account adjustments to Revenue Cycle Manager and post in KanTime once approved.
• Assist as needed with payer authorizations and verification as required and completed documentation in KanTime.
• Protects the confidentiality of patient and organization information through effective controls and supervision of billing operations.
• The incumbents may be requested to perform job-related tasks other than those stated in this description.

SKILLS AND COMPETENCIES:

• Maintains comprehensive working knowledge of government billing regulations and managed care contract requirements for Hospice billing.
• Adept at utilizing organization electronic billing systems.
• Engage in creative problem solving to understand issues and find solutions.
• Ability to meet deadlines.
• Demonstrates ability to adapt to daily departmental needs as changes occur.
• Ability to coordinate multiple tasks simultaneously.
• Demonstrates ability to utilize Microsoft Office products.
• Ability to maintain all required HIPAA privacy laws as it relates to this position.
• Good communication and interpersonal skills.

Gulfside Healthcare Services is a community-based nonprofit organization providing hospice and palliative services in Pasco County, and home health care throughout Pasco and Pinellas counties for over 30 years. We are there when our patients need us the most - providing comfort care for those living with a life-limiting illness, their loved ones and those who have lost someone special in their lives. Patients in Gulfside's care know dignity, peace and comfort through the support and understanding of our professional staff and dedicated volunteers.

Gulfside Healthcare Services provides an excellent benefits package to all full time employees including affordable healthcare, dental, vision, Employee Assistance Program (EAP), FSA and HSA options, company sponsored life insurance and long term disability, matching 403b contributions, generous paid time off allocation, paid holidays, and tuition reimbursement. We also partner with Regions, AFLAC, Rasmussen College, Sam's Club, and the YMCA for value added voluntary employee benefits.

Our vision is to be the Provider of Choice for people in need and the Employer of Choice for talented, skilled and creative professionals.

Gulfside Healthcare Services is committed to a Drug Free Workplace and all positions are subject to drug testing.

It is the policy of Gulfside Healthcare Services, Inc. to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, marital status, status with regard to public assistance, status as a disabled veteran, recently separated or other covered veteran, or an other characteristic protected by federal, state or local law.