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Company

GrandCare Health ServicesSee more

addressAddressPasadena, CA
type Form of workFull-Time
salary Salary$20 to $27 Hourly
CategoryHuman Resources

Job description

Job Description

Are you ready to join GrandCare Health Services?

Join our team of recognized leaders in the provision of in-home healthcare in Southern California. Our commitment to excellence and clinical innovation has enabled us to ensure our patients receive the highest quality medical care in the comfort of their homes since 2003.


GrandCare Health Services specializes in post-surgical orthopedic programs. Our agencies are licensed by the Department of Public Health of California and have earned top quality-of-care scores from Medicare.

Why Choose GrandCare Health Services?

  • We have been recognized as one of America's top places to work in healthcare for 3 years in a row by organizations like Forbes Magazine. Click here to see why
  • We are leaders in the growing Orthopedic Rehabilitation market
  • We are a growing company with opportunity for top people to grow
  • Excellent Medical, Dental, and Vision Coverage with low cost to employees
  • 401(k) Retirement Plan with company matching
  • Free company-paid Life Insurance Policy
  • Paid Time Off
  • Paid Sick Time

The Team Member We Are Searching For


The ideal Billing and Collections Specialist will be responsible for collections, appeals, and denials as well as claims management. The candidate is required to have experience in commercial and managed care collections. The incumbent will need to possess a positive demeanor, good verbal and written communication skills, and be professional in both appearance and approach.

The Collections Specialist, working independently, must use their strong interpersonal and persuasive abilities to secure accurate and timely payment from third party payers.

They must display both assertiveness and compassion in resolving accounts and take the appropriate action to resolve disputes related to covered services.

It is important that the Collections Specialist both understand the transaction and be able to explain the transaction and expected outcome.

This position will be responsible for resolving outstanding insurance balances and compliantly maximizing reimbursement from insurance carriers.

What you’ll need to accomplish:


  • Take responsibility for patient billing for Medicare, Insurance, and Private Pay by:
  1. Entering patient/client data into the computer accurately and in a timely manner
  2. Maintaining billed/unbilled patient logs
  3. Maintaining patient status changes regarding billing
  4. Submitting claims to government agencies, insurance payers, pharmacies and private payers are issued accurately and in accordance with the appropriate contracts
  1. Billing and collecting Medicare/Medicare Advantage claims on a timely basis and compliant out-of-pocket financial responsibilities are billed and collected on a timely basis.
  1. Following up on all claims from billing through final resolution (payment errors, denials, appeals etc.)
  1. Highlighting and reporting uncollected accounts to management
  2. Ensuring insurance billing requirements and reimbursement rates are kept up to date
  1. Organizing and maintaining billing mail correspondence & reply on a timely basis
  1. Responding to patient and internal requests received via email within 24 hours
  1. Uploading Oasis to CMS website when needed

  • Utilize insurance accounts receivable reports, billing system tasks, payer web portals, and other tools to follow-up on outstanding balances

  • Coordinate and responds to requests for further billing information and/or medical records

  • Prepare monthly reports and weekly/daily claim submissions

  • Organize all required paperwork for billing

  • Maintain accurate Medicare and Insurance billing analysis reports (logs)

  • Maintain complete and accurate patient/client billing records

  • Communicate with appropriate supervisors regarding late or missing documents required for billing

  • Perform other specific projects relating to billing and data entry as required


What do we require from you?

Minimum Qualifications

Education:

  • High School Diploma or GED required

Experience:

  • One year experience in clerical or administrative work strongly preferred
  • Prior experience working in the home health industry preferred

Skills and Abilities


  • Excellent communications, both written and verbal, organizational, presentation and facilitation skills
  • Self-directed with the ability to work with little supervision
  • Excellent observation skills and multi-tasking skills
  • Flexibility and cooperation in fulfilling role obligation
  • Ability to maintain confidentiality in all aspects of the job
  • Ability to respect/protect the confidentiality of information in patient and employee records
  • Ability and knowledge of how to protect documents in a manner that prevents unauthorized access
  • Basic knowledge and use of computers and use of Microsoft Windows required
  • Basic use of Microsoft Office programs (Word, Excel, Outlook, PowerPoint, etc.)
  • Basic phones operations, phone etiquette, filing, copying, faxing, and scanning

Disclaimer: GrandCare Health Services is dedicated to encouraging a supportive and inclusive culture amongst the whole workforces. We aim is to ensure that all employees and job applicants are given equal opportunity and that our organization is representative of all sections of society. We do not discriminate based on race, color, ancestry, national origin, religion or religious creed, mental or physical disability, medical condition, genetic information, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity, gender expression, age, marital status, military or veteran status, or citizenship.

Refer code: 3222686. GrandCare Health Services - The previous day - 2023-03-19 21:26

GrandCare Health Services

Pasadena, CA
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