Insurance Billing Specialist

Community Name:

Essential Functions Statement(s)

• Reviews and edits insurance claims
• Manages the billing process for Medicare, Medicaid and/or third party insurance claims for assigned facilities
• Manages the process for Medicare bad debts and coinsurance billing to Medicaid
• Handles co-insurance follow-up for Medicare and other third party, and self-pay billing and payments
• Manages the insurance claims A/R follow-through from beginning to end
• Ensures Revenue Cycle Manager verifies anything outside of regular claims submission before processing
• Disputes claim rejections with insurance companies as necessary
• Oversees facilities issues with insurance companies as necessary
• Prepares status reports on A/R aging for assigned facilities
• Possesses knowledge of Medicare, Medicaid and third party payor or billing rules
• Performs all other duties as assigned or directed

Competency Statement(s)

• Accountability - Ability to accept responsibility and account for his/her actions.
• Accuracy - Ability to perform work accurately and thoroughly.
• Communication, Oral - Ability to communicate effectively with others using the spoken word.
• Communication, Written - Ability to communicate in writing clearly and concisely.
• Customer Oriented - Ability to take care of the customers' needs while following company procedures.
• Detail Oriented - Ability to pay attention to the minute details of a project or task.
• Honesty / Integrity - Ability to be truthful and be seen as credible in the workplace.
• Interpersonal - Ability to get along well with a variety of personalities and individuals.
• Organized - Possessing the trait of being organized or following a systematic method of performing a task.

Skills & Abilities

• Education: Associate's Degree (two year college or technical school): Required
• Experience: Two (2) or more years of experience required
• Computer Skills: Must be proficient at operating a computer, the Internet and basic office equipment; Must have strong data entry skills
• Certifications & Licenses: Must obtain and maintain mandatory, state, federal requirements and certifications for practice or occupation; Prior skilled nursing billing experience in a managed care facility, or related area, required
• Other Requirements: Must be committed to participate in continuing education; Must have strong written and verbal communication skills; Must have strong data entry skills; Must be able to adhere to all terms and conditions set forth in the United Church Homes Employee Handbook

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.