Payroll/Billing - (Must be able to utilize Availity) Fayetteville, GA
Sanzie Healthcare Services Inc is looking for an In-home care Billing and Payroll Accounting Clerk. The Biller/Payroll Accounting Clerk position is responsible for billing, collecting, posting and managing account payments. The ideal candidate will be required to investigate claims issues and staying afloat of account receivables. A strong background in medical billing, with the skills necessary to improve our current billing procedures and collecting on patient accounts.
Responsibilities include:
- Understand and adhere to established SHCS policies and Procedures
- Assist with recruiting, associate hiring, orientations, in-services, disciplinary actions, etc.
- Perform payroll duties including verifying time sheets and/or Telephony processing. Computer input of timesheet/Telephone changes for payroll processing.
- Preparing and submitting claims to various insurance companies electronically
- Enters new employee data into the payroll and processes payroll
- Resolving unpaid claims identified on aged A/R and various other reports, and also reviewing and responding to all billing-related correspondence
- Denial trends are researched and root causes are identified and reported to the Administrator for resolution
- Company Payroll
- Answering and triaging calls from caregivers, clients, insurance companies, and prospects
- Identifying and resolving insurance/patient billing complaints
- Assisting in recruiting on various job boards
- Sending MIF, CCNF, and calling VA regarding any expired Prior Authorizations
- Preparing, reviewing, and sending patient statements
- Ensuring all documents are submitted for proper billing: insurance verification forms, office notes, and encounters/superbills
- Reporting delinquent accounts to the Administrator & CEO
- Performing various collection actions including contacting Clients by phone, correcting and resubmitting claims to third-party payers
- Participating in educational seminars and staff meetings (monthly or weekly)
- Maintaining the strictest confidentiality and adhering to all HIPAA guidelines and regulations
- Such other tasks as the company may require and/or as needs evolve
- Generating, reviewing, and transmitting claims
- Payment Posting- Mail & ERA's
- Provide customer service regarding billing & collection issues, process and review account adjustments, and resolve client discrepancies and short payments.
- Follow up on submitted claims to ensure payer acceptance.
- Review rejected and/or denied claims, make corrections, and resubmit clean claims within the required time frame
- Review EOBs/ ERA's for any missed opportunities
- Follow up on aged accounts receivables through final resolution
- Balance bill secondary, and tertiary insurance as well as patients
- Follow up on payment errors, over-payments, low reimbursements, rejections and denials
- Insurance verification
- Other duties as assigned based on billing, payment posting, and demographic entry, to ensure company goals are met and a team environment is maintained
- Maintain the confidentiality of the medical information contained in each record.
- Recording, monitoring, and processing Company QuickBooks.
Reviewing timesheets
- Review the client's Pre authorized units/hours and dates given by Medicaid, VA, Private pay, etc. are placed correctly on Axiscare.
- Review and approve timesheets and payroll information of assigned staff -Check each employee's Timesheets, member form, and Progress note to reflect Axiscare.
- Input the correct hours on the Excel and process payroll and timesheets by the company pay period.
Key Requirements:
- Ability to research unpaid claims, determine and correct cause, and follow up as needed.
- Ability to appeal/rebill underpaid or denied claims within payer deadlines.
- Knowledge of CPT, HCPCS, and ICD-9 codes; familiarity with regional and national payers (including Medicaid, VA, Medicare HMO and Medi-Cal HMO plans).
- Should be proficient with MS Office (Word, Excel, Outlook) and have experience working in multiple billing software systems (Availity and MMIS experience a big plus!).
- Must have a minimum of 3 years of comprehensive medical billing/collections experience with multiple specialties and a well-rounded understanding of the entire Revenue Cycle process.
- Commitment to excellent customer service a must
- Excellent written and verbal communication skills
- Ability to prioritize and manage multiple responsibilities
- HIPAA Compliant
Working Hours/Salary:
Part-time; Compensation to be determined upon review of credentials and experience.
Hours 9.00 am- 6:00 pm Monday - Friday.
Required experience/ education:
- 3+ years' experience in medical billing, posting charges, insurance verification, payment posting, filing professional claims, & ICD-10
- Certification not required, but is a plus
- Associate Degree or equivalent
- Proficient in billing software Availity and MMIS software
- Strong analytical skills
- Experience in medical terminology, accounts receivable, insurance collections and billing
- Experience with HIPAA standards and compliance programs
- Knowledge of medical billing/collections practices
- Knowledge of computer programs
- Ability to operate a computer, basic office equipment and a multi-line telephone system
- Knowledge of basic third party operating procedures and practice
- Knowledge of Medicare/Commercial Payors and Workers Comp
- Skill in answering a telephone in a pleasant and helpful manner
- Strong organization, oral/written communication and public relations skills
- Ability to maintain effective working relationships with patients, employees and the public
Job Type: Full-time
Required education:
- Associate degree or equivalent
- Certified Biller and Payroll Clerk
Required experience:
- In home care billing experience : 2 years
- Medical Billing: 2 years
- Payroll Experience: 2 years