Genesis Healthcare Specialist Collections (Full Time) in Kennett Square, Pennsylvania
Ensure claims/bills are produced according to payor and regulatory requirements to assure remittance at first pass; business goals are:
Improve Quality of Bills Produced prior to formal bill submission
May assist Billing Specialist Team in meeting initial bill submission deadlines.
Process Primary and Secondary Commercial Insurance claims, e.g. Long Term Insurance, Motor Vehicle, Workmen's Compensation,
Liaise with Center Staff to ensure verifications, authorizations, and documentation requirements meet payor requirements for claim submission
Prepare final bill for submission, e.g. UB92 and include supporting documentation using prescribed format.
Follow up on any/all unpaid claims.
Maintain records, files and logs of claim status or other billing information as directed.
Interact with Third Party Payors as required to obtain payment for pending claims.
Prepare adjustments/corrections to Commercial Bills.
Refer problems or rejected claims to Specialist, Claims Resolution.
Assure accuracy of demographic information in the Billing System to ensure accurate billing and prompt payment.
Resolve Claim Denials:
Contact payor regarding claims issues, problems or failure to pay.
Assure claim is complete in order for carrier to process promptly.
Submit supplemental information if required.
Influence Payor Representative to review claims during call and communicate status.
Re-submit claims, bills in response to billing errors.
Review Denials and re-submit bill.
Process adjustments/corrections for Private Pay and Commercial claims/bills.
Process non-Medical Appeals and Timely Filing Appeals to resolution.
Notify SNF staff of customer loss of payor status and timely processing of payor sequence.
Perform follow-up activities to assure commercial insurance payments are received.
SPECIFIC EDUCATIONAL/VOCATIONAL REQUIREMENTS: 1. Associate's Degree of 2 or more years in healthcare or long-term care billing and collections. 2. Experience with healthcare billing software 3. Enjoys working in high volume environment.
Position Type: Full Time
Req ID: 286859
Center Name: Genesis HealthCare
Genesis HealthCare, Inc. and all affiliated entities (collectively, “Genesis”) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, gender expression, gender identity, sexual orientation, national origin, age, actual or perceived disability, marital status, pregnancy, genetic information, amnesty, military status or status as a covered veteran in accordance with applicable federal, state, and local laws. Genesis takes affirmative action to employ and advance in employment qualified minorities, women, individuals with disabilities and covered veterans. These policies are fully supported by the CEO, COO and all members of the leadership team. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact (877)456-6726. This phone number is for ADA related accommodation requests only, not for routine employment inquiries.