Job Description

Job Description

Job Description

Established nurse registry, providing private duty home care referrals is seeking an individual experienced in billing and claims. The ideal candidate would thrive in a position with set, regular deadlines. Your desire to delivery consistency with special attention to accuracy should be matched only by an equally strong urge to excellent customer service. You should be proficient in navigating basic office technology like Microsoft Office Suite, the company's chosen EMR, and an ability to learn payor clearinghouses. This department works in coordination with local branch offices to process claims on the behalf of hundreds of contractors and their clients each week. It is imperative to the success of the company that we deliver on this service in a clean, reliable manner through the billing and claims department. This is a fully remote position, however some on-site presence could be required in rare instances. Working hours for this position are non-negotiable and attendance is Monday - Friday from 8:30 AM - 5:00 PM. 

Duties/Responsibilities:

· Billing and Invoicing: Prepare and submit accurate and timely billing invoices for services provided by home healthcare professionals to insurance companies, the client, Medicaid, and other third-party payers.

· Documentation Review: Review caregiver timesheets to ensure compliance with billing regulations and requirements.

· Claims Processing: Prepare and submit claims electronically or via paper, ensuring all required supporting documents are included to facilitate timely reimbursement.

· Payment Tracking: Monitor and track the status of submitted claims, follow up with payers, and resolve any issues or denials to maximize revenue collection.

· Reimbursement Optimization: Identify opportunities to maximize reimbursement by staying updated on the latest billing and coding guidelines, fee schedules, and reimbursement policies.

· Billing Audits: Conduct regular audits to ensure compliance with regulatory guidelines, identify potential areas of improvement, and implement corrective actions as needed.

· Documentation Management: Maintain organized and secure electronic records of billing-related documents, ensuring confidentiality and adherence to data protection regulations.

· Collaboration and Communication: Collaborate effectively with internal teams and caregivers, including, administrative staff, and finance department, to resolve billing-related issues and streamline processes.

· Billing Support: Provide assistance and support to caregivers, their clients and clients families in understanding billing statements, claims, and payment options.

· Training and Education: Stay updated on industry changes, attend relevant workshops, and actively participate in training programs to enhance knowledge and skills related to billing and coding practices.

· Observe HIPAA at all times

· Participate in company CEMP when enacted

· Utilize best practices to always observe nurse registry compliance with Florida statutes and regulations

· Other responsibilities as assigned by management

Required Skills/Abilities:

· Strong knowledge of medical billing procedures and healthcare reimbursement regulations (Medicaid, Private Care, Long Term Care).

· Proficiency in using medical billing software.

· Familiarity with insurance verification and claims processing procedures.

· Excellent attention to detail and accuracy in data entry and documentation.

· Strong analytical and problem-solving skills to resolve billing issues and denials effectively.

· Effective communication skills, both written and verbal, to interact with internal teams, caregivers, clients.

· Ability to prioritize tasks, meet deadlines, and manage multiple projects simultaneously.

· Knowledge of HIPAA regulations and commitment to maintaining client confidentiality.

· Professionalism, integrity, and commitment to providing exceptional customer service.

· Ability to pass and maintain an eligible Level 2 background check through the Agency for Healthcare Administration

Education and Experience:

· High school diploma or equivalent required.

· Proven experience as a Billing Specialist in the home healthcare industry or a similar healthcare setting.

Physical Requirements:

· Ability to sit for prolonged periods at a desk, working on a computer.

Ability to lift 25 lbs. if needed

VIP America, LLC is a state licensed nurse registry. We refer professional independent care providers to the elderly and disabled residents of our counties of licensure. We are a small company, with a long standing history of great service to those in need.

Company Description

VIP America, LLC is a state licensed nurse registry. We refer professional independent care providers to the elderly and disabled residents of our counties of licensure. We are a small company, with a long standing history of great service to those in need.

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