Job Title: Senior Medical Billing Specialist
We are hiring to create a team of Medical Billing Experts for our US Based sister company Heal Home Health. We are looking forward to create a team and we are in search of people having 3-5 years of Experience in health care industry of USA with leadership skills.
Location: onsite (New Blue Area, Islamabad)
About HEAL Home Health:
HEAL Home Health is a leading provider of professional home healthcare services in USA. We are dedicated to delivering high-quality patient care in the comfort of their own homes. We are looking for a meticulous and experienced Medical Billing Expert to join our team and ensure accurate and timely reimbursement for our valuable services.
Job Summary:
The Medical Billing Expert will be responsible for managing all aspects of the medical billing and collections process for HEAL Home Health. This role requires a deep understanding of home health billing regulations, coding, and payer requirements to maximize revenue and ensure compliance. The ideal candidate will be detail-oriented, possess strong analytical skills, and be proficient in various billing software and electronic health record (EHR) systems and should have experience of working with healthcare industry of USA.
Key Responsibilities:
1. Claims Submission: Prepare, review, and submit accurate and timely electronic and paper claims to various insurance payers (Medicare, Medicaid, commercial insurance, private pay, etc.) for home health services.
2. Coding & Compliance: Ensure all services are coded correctly using appropriate ICD-10-CM, CPT, and HCPCS codes relevant to home health. Stay updated on all coding guidelines and payer-specific requirements.
3. Rejection & Denial Management: Investigate, correct, and resubmit rejected and denied claims efficiently. Identify root causes of denials and implement strategies to prevent future occurrences.
4. Payer Relations: Communicate effectively with insurance companies to resolve claim issues, verify benefits, obtain authorizations, and follow up on payment statuses.
5. Patient Billing & Collections: Process patient statements, handle patient inquiries regarding bills, and manage patient collections when applicable.
6. Payment Posting: Accurately post payments received from insurance companies and patients to patient accounts. Reconcile payment discrepancies.
7. Accounts Receivable Management: Monitor aging accounts receivable, perform regular follow-up on outstanding claims, and work to minimize overdue balances.
8. Reporting & Analysis: Generate regular reports on billing activities, denial rates, payment trends, and A/R status. Analyze data to identify areas for improvement and efficiency.
9. Documentation Review: Review patient charts and documentation to ensure services rendered are supported and accurately reflect billing codes.
10. Policy & Procedure Adherence: Adhere strictly to all HIPAA regulations, federal and state billing compliance guidelines, and company policies and procedures.
Qualifications:
• Education: High school diploma or equivalent required. Associate's or Bachelor's degree in healthcare administration, finance, or a related field preferred.
• Experience: Minimum of 3-5 years of progressive experience in medical billing, specifically within a home health or hospice setting in USA Industry.
• Knowledge: In-depth knowledge of Medicare, Medicaid, and commercial insurance billing regulations, coding (ICD-10-CM, CPT, HCPCS), and compliance.
• Technical Skills: Proficiency with medical billing software (e.g., Brightree, Kinnser, MatrixCare) and Electronic Health Record (EHR) systems. Strong proficiency in Microsoft Office Suite (Excel, Word, Outlook).
Job Type: Full-time
Pay: Rs80,000.00 - Rs160,000.00 per month
Work Location: In person
