Billing Specialist

2+ years

$40,000 to $45,000 per year

Stuart

10 Nov. 23, 2024

Job Description

Job Type: Full Time Education: B.Sc./M.Sc./B.Pharm/M.Pharm/Life science Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Job Title: Medical Billing and Claims Specialist

Employer: VIP America, LLC
Location: Fully Remote (Occasional on-site presence may be required)
Schedule: Monday – Friday, 8:30 AM – 5:00 PM

About Us

VIP America, LLC is a state-licensed nurse registry that refers professional independent care providers to elderly and disabled residents across licensed counties. With a history of excellent service, our small team is committed to meeting the needs of our clients and their families with professionalism and care.

Position Overview

We are seeking a detail-oriented Medical Billing and Claims Specialist to join our team. The ideal candidate thrives on meeting regular deadlines, ensures accuracy in their work, and is passionate about delivering exceptional customer service. This role involves processing claims and invoices for private duty home care services, collaborating with internal teams, and ensuring compliance with regulatory requirements.

Key Responsibilities

Billing & Claims Processing

Prepare and submit accurate and timely invoices for services provided to insurance companies, Medicaid, private pay clients, and third-party payers.
Process electronic and paper claims, including required supporting documentation, to facilitate timely reimbursements.
Monitor the status of submitted claims, follow up on denials, and resolve outstanding issues.
Review caregiver timesheets for compliance with billing regulations.

Revenue Optimization

Stay current on billing and coding guidelines, reimbursement policies, and fee schedules to identify opportunities for maximizing revenue.
Conduct regular billing audits to ensure compliance with regulations and improve processes as needed.

Documentation & Compliance

Maintain secure and organized electronic records of billing documents, adhering to HIPAA and data protection regulations.
Ensure compliance with Florida statutes and regulations governing nurse registries.
Participate in the company’s Comprehensive Emergency Management Plan (CEMP) as required.

Collaboration & Support

Communicate effectively with caregivers, administrative staff, and finance teams to resolve billing-related issues.
Provide support to clients, their families, and caregivers in understanding billing statements and payment options.
Assist with other duties as assigned by management.

Required Skills and Qualifications

Strong understanding of medical billing procedures and healthcare reimbursement regulations (e.g., Medicaid, private care, long-term care).
Proficiency in medical billing software and payor clearinghouses.
Familiarity with insurance verification and claims processing.
Excellent attention to detail and accuracy in data entry and documentation.
Strong analytical and problem-solving skills to address billing issues and denials.
Effective written and verbal communication skills for interacting with caregivers, clients, and internal teams.
Knowledge of HIPAA regulations and a commitment to maintaining client confidentiality.
Professionalism and dedication to exceptional customer service.
Ability to pass and maintain a Level 2 background check through the Agency for Healthcare Administration.

Education and Experience

High school diploma or equivalent required.
Proven experience in medical billing within the home healthcare industry or a similar healthcare setting.

Physical Requirements

Ability to sit for prolonged periods while working on a computer.
Capability to lift up to 25 lbs. if necessary.

Why Join VIP America?

At VIP America, we take pride in our long-standing history of serving the elderly and disabled with compassionate, high-quality care referrals. Join our team and help us continue delivering the reliable and professional service we’re known for.

For more information, please visit our website or contact us directly.

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