Atlanta, Georgia
Medicare Billing Specialist Job Opening in Atlanta, Georgia - CitySide Healthcare, Inc. is a behavior healthcare agency that provides comprehensive counseling and therapeutic services to children, adolescents, families and adults.
We are hiring for a Medicare Billing Specialist:
Job Description:
The Medicare Billing Specialist is responsible for processing client enrollment and billing transactions timely and accurately as well as ensures our Medicare Program meets state mandated requirements for Behavioral Health Services. In this role, the Specialist will be responsible for analyzing and evaluating enrollment in addition to billing operational performance and processes through internal and external discussions with management and business stakeholders. As well as, establish and implement process improvement initiatives that will strengthen quality and performance leading to operational excellence while maintaining compliance through reporting, quality monitoring and the oversight of activities.
Minimum Qualifications:
A minimum of 2 years Medicare claims processing experience
Knowledge of Medicare Advantage Plan processes and Centers for Medicare & Medicaid Services (CMS) guidelines for plan enrollment and billing.
Preferred knowledge of behavioral health agency billing and business office operations.
Strong analytical, organizational and critical thinking skills with a high attention to detail.
Ability to work independently as well as with all levels of staff, leadership and external partners and stakeholders.
Proven problem solving skills and ability to translate knowledge to corporate departments
Experience with Microsoft Office suite products and strong computer skills
Character to maintain strict confidentiality.
Exercise good judgment and makes sound decisions in the absence of detailed instructions or in an emergency situation.
Responsibilities:
Follow enrollment & billing processes and systems to ensure data quality to support the Company's quality, production and financial goals
Process enrollment and billing activities including but not limited to; client bills, payments, correspondence and enrollment transactions per established processes and procedures
Prepare an intended use plan for various Medicare Plans; Part A, Part B, Part C and Part D
Participate in the department audit/oversight program that focuses on continuous quality improvement. Support all CMS and internal audit activities as needed.
Prepare and complete weekly reports, identify challenges and solution for correction for an opportunity to improve Medicare services and processes
Participate in ongoing collaboration and training on Medicare requirements for Behavioral Health Services
Support and participate in system testing and requirements gathering related to operational readiness updates on system enhancements, CMS software releases as needed
Performs all of the tasks necessary to maintain current and accurate account information in each of the appropriate systems (i.e. entering notes, claims on hold, denials).
Reviews all claims for completeness, reasonableness of charges, and appropriateness of billing codes, and payer information.
Pursues timely collection of each claim using thorough follow-up efforts appropriate to each payer.
Handles all incoming phone calls and inquiries in an appropriate manner. Properly process and respond to incoming correspondence.
Contacts and effectively communicates with all parties involved in the resolution of accounts placed.
Provide administrative oversight to ensure EMR is in compliance with state regulation.
LOCAL CANDIDATES ONLY (Metro Atlanta Area)
Due to the high volume of resumes we receive please do not contact the office directly regarding this post or to follow-up on your submission. Only qualified candidates will be contacted for an interview.
Job Type: Full-time
Required experience:
Medicare Claims Billing: 2 years
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