Home Health Medical Office personnel -Experience using Availity RCM, MMIS, QuickBooks Job at Sanzie HealthCare Services Inc, Fayetteville, GA

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  • Sanzie HealthCare Services Inc
  • Fayetteville, GA

Job Description

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
Sanzie HealthCare Services Inc

Job Tags

Full time, Part time, Home office, Monday to Friday,

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