Traditions Health Care - Nashville, TN
posted about 2 months ago
Full-time - Entry Level
Nashville, TN
Nursing and Residential Care Facilities
About the position
The Medical Billing Specialist is responsible for coordinating the billing functions of Traditions Health in compliance with state, federal, and local regulations. This role involves ensuring accurate and timely submission of claims, managing accounts receivable, and resolving billing discrepancies. The position emphasizes collaboration with various stakeholders to maintain compliance and enhance the efficiency of billing operations.
Responsibilities
- Ensure all documents are present within electronic medical record and submitted timely and accurately according to Medicare standards.
- Collaborate with service location contacts, third party institutions, and other team members to resolve billing inconsistencies and errors.
- Ensure accurate and timely submission of claims, understanding and interpreting guidelines of various insurances and payors.
- Stay up to date with insurance/payors regulations to maintain compliance and prevent potential issues.
- Accurately document billing activities in EMR, ensuring transparency and accountability.
- Efficiently manage accounts receivable, pursuing unpaid balances.
- Resolve billing and collection issues and discrepancies swiftly and effectively.
- Continuously monitor billing and collection activities, identifying potential issues, discrepancies, and trends.
- Communicate any billing discrepancies, collection concerns, or potential issues promptly to the Billing Manager for proactive resolution.
- Ensure compliance with local, state, and federal regulations and the agency's policies and procedures.
Requirements
- High school diploma or equivalent.
- Experience in a medical-related field, preferably in Home Health/Hospice.
- Knowledge of billing and CMS regulations.
- Experience with EMR/Software such as HomeCare Home Base, Availity, Waystar/medical claims clearinghouse.
- Excellent attention to detail and accuracy in data entry.
- Strong organizational and time management skills.
- Effective communication skills, both written and verbal.
- Ability to work independently and as part of a team.
- Self-starter and highly resourceful.
- Strong mathematical skills for calculating remittances, payments, and reconciling accounts.
Nice-to-haves
- Familiarity with medical billing processes, claims submission, and claim denials.
- Experience in making outbound calls to payors for payment resolution or collections purposes.
- Problem-solving and critical thinking skills to identify and correct claim issues.
Benefits
- 401(k) matching
- Health savings account
- Opportunities for advancement
- Paid time off
