Medicare Recert Billing/Collections Specialist II
Posting ID: JP-001976862
Position Overview: Accurately evaluate incoming delivery and/or subsequent cycle documentation as well as initial orders ready for review to determine proper claim submission for reimbursement or adjustments based on departmental business procedure and understood Medicare reimbursement criteria. Duties and Responsibilities: • Conducting a full review of every active account based on the appropriate time frame required • Manage documents in MDC Recert and MDC BillPending workbaskets in a timely manner and update VAC Recert accordingly. • Return orders to appropriate business department/CSR for corrections which cannot be resolved with information provided. • Verify that VAC Recert Tracking program is properly updated with correct start bill and cycles dates as well as cycle and processing statues including Wound Tracking • Perform quality assurance check of documentation that has been submitted based on department guidelines. • Review all incoming claims-related paperwork for completeness; note acceptance or exceptions and follow up on missing information to ensure claims are processed in a timely manner • Ensure all payer and internal requirements are met for each order and ensures proper documentation is kept. • Determine what claims will be sent to Medicare and how based on the use of several analysis processes and programs provided for this review • Verify that all necessary information loaded into Delair billing system is correct • Verify that all charges in billing system are posted with correct dates of service, modifiers and adjustments. • Apply proper status codes on corresponding charges lines for pending actions or document deficiencies for correct unbilled allocation or department process • B code any documents audited and used for supporting billing of claim with appropriate cycle • Maintain C&C database entries for actions required in a timely manner • Document and notify appropriate personnel to assist with the recertification procedure. • Maintain courteous and timely communication with all customers at all times. • Participates in any and all reasonable work activities as may be deemed suitable and assigned by management. • Trouble shoot and problem solve any issues that arise and apprise management of any issues • Follow-up with all corrections required in an accurate and timely manner • Adhere to departmental standards, expectations and Service Level Agreements • Conforms to, supports and enforces all Company policies and procedures. • Performs all other duties as assigned
medical record, medical terminology, customer service, call center, health care, medical billing, medical claims processing
Top Skills Details:
medical records call center Medical billing Medical terminology
Additional Skills & Qualifications:
Qualifications & Skills: REQUIRED: Basic Qualifications: • High School Diploma or equivalent. • Personal computer experience with a high-level Word and Excel competency, MS Office applications. • Three to five years’ experience within healthcare, medical billing, customer service, or relevant field PREFERRED: Additional preferred qualifications: • Demonstrated analytical, problem-solving and organizational skills • Demonstrated ability to communicate effectively, both verbally and in writing. • Demonstrated ability to work effectively in a team environment, as well as, independently • Must be able to participate in all required training programs. • Demonstrated ability to deal effectively with all employees and external business contacts while conveying a positive, service-oriented attitude. • Demonstrated ability to maintain complete confidentiality and discretion in business relationships and exercise sound business judgment. • Some College a plus • Ability to type at least 40 WPM ESSENTIAL FUNCTIONS: Requires repetitive keyboarding over 95% of the time
We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing® Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Recruiter: Karmin Edgerly