Website Adapthealth
Qualifications
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Decision Making
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Analytical and problem-solving skills with attention to detail
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Strongverbal and written communication
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Excellent customer service skills
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Proficient computer skills and knowledge of Microsoft Office
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Ability to prioritize and manage multiple tasks
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Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
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High School Diplomaor equivalent
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One (1) yearwork related experience in health care administrative, financial, or insurancecustomer services, claims, billing, call center or management regardless of industry
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Senior level requires two (2) years of work-related experience and one (1) year of exact job experience
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Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance
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Subject to long periods of sitting and exposure to computer screen
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Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use
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Must be able to lift 30 pounds as needed
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Excellent ability to communicate both verbally and in writing
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May be exposed to angry or irate customers or patients
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Responsibilities
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The Provider Side Medical Billing Specialist is responsible for proper billing of and collections from third party insurance companies
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This position will be expected to review reports, corrected denied claims, and work with multiple insurance plans throughout the US
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Review claims prior to claim submission and edit as needed per the payer’s requirements
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Analyze and update claims on hold to ensure hold reason is rectified before it is submitted
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Review tied items and HCPCS codes against known requirements to ensure accurate processing and payment of claims
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Work clearinghouse or payer level rejections to resolve claim issues
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Work necessary reports to ensure that claims are being followed up on to maximize receivables
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Review client’s insurance and determine next proper steps of account following the payer’s guidelines
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Learn and obtain understanding of refunds, credits and adjustment procedures
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Document accounts properly with actions requested, taken, or with pertinent information for future reference
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Review assigned payer requirements on a consistent basis for any fee schedule updates, in addition to reviewing payer notifications received via mail, email, or websites and alerting supervisor of any changes
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Communicate and collaborate with team members and other departments to resolve internal and external customer concerns via email, fax or phone
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Perform all duties and responsibilities in compliance with all State, Federal, and Company policies
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Educate patients, staff and providers regarding authorization requirements, payer coverage, eligibility guidelines, documentation requirements, andinsurancechanges or trends
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Maintains an extensive knowledge of different types of payer coverage, insurance policies, payer guidelines and payer contracts ensure accurate billing and timely payment is received
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Responsible for entering data in an accurate manner, into database including although not limited to payer, authorization requirements, coverage limitations and status of any requalification
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Collaborates withphysicianoffices, AdaptHealth sales and support staff to ensure timely receipt of documentation as well as educating, as necessary
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Identify trends and providing feedback andeducationto internal and external customers on compliantdocumentationrequirements for services provided
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Performs other related duties as assigned
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Work environment may be stressful at times, as overall office activities and work levels fluctuate
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Must be able to bend, stoop, stretch, stand, and sit for extended periods of time
Benefits
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Medical
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Dental
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Vision
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Paid Time Off
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401k
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To apply for this job please visit www.ziprecruiter.com.