Billing Specialist I - Senior Living Organization

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<p><span style="color: #000000;">Billing Specialist </span></p> <p><span style="color: #000000;">The Carmelite System is a multi-state, not-for-profit senior living organization sponsored by the Carmelite Sisters for the Aged & Infirm operating a network of Skilled Nursing Facilities and Assisted Living/Independent Living communities.</span></p> <p><span style="color: #000000;">We are seeking to hire a <strong>Billing Specialist I</strong><strong>.</strong></span></p> <ul> <li><span style="color: #000000;"><strong>This corporate level position is fully remote.  Current Team members work in Eastern and Central Standard Time.    </strong></span></li> <li><span style="color: #000000;"><strong>$15.50 to $26.44 per hour based on skills and experience.</strong></span></li> </ul> <p><span style="color: #000000;"><strong>Billing Specialist I Qualifications:</strong></span></p> <ul> <li><span style="color: #000000;">High School diploma or equivalent.</span></li> <li><span style="color: #000000;">Extensive knowledge of Medicare, Medicaid, managed care networks and insurance carriers required.</span></li> <li><span style="color: #000000;">Extensive knowledge of accounts receivable functions including CPT and ICD-10 coding required.</span></li> <li><span style="color: #000000;">Solid understanding of the current Medicare Compliance, OSHA, and HIPAA regulations and medical terminology required.</span></li> <li><span style="color: #000000;">Strong basic mathematical skills required.</span></li> <li><span style="color: #000000;">Understanding of Medicaid, Medicare, and Third Party Billing preferred.</span></li> <li><span style="color: #000000;">PCC (Point Click Care) experience preferred.</span></li> </ul> <p><span style="color: #000000;"><strong>Billing Specialist I Job Summary:</strong></span></p> <ul> <li><span style="color: #000000;">Prepare, review, and transmit claims using billing software.</span></li> <li><span style="color: #000000;">Analyze explanation of benefits forms to review denial codes and make appropriate corrections.</span></li> <li><span style="color: #000000;">Follow up on balances, unpaid claims, appeals & denials within the set timeframe.</span></li> <li><span style="color: #000000;">Post payments and adjustments to accounts and maintain backup records.</span></li> <li><span style="color: #000000;">Maintain patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Ensure proper records handling.</span></li> <li><span style="color: #000000;">Input ancillary charges into the billing software in accordance with protocol.</span></li> <li><span style="color: #000000;">File all charge, payment, adjustment batches, refund requests and write off requests in the appropriate format and location (PCC and shared drive).</span></li> <li><span style="color: #000000;">Prepare and review claims for billing prior to triple check.</span></li> <li><span style="color: #000000;">Attend and lead monthly triple check reviews.</span></li> <li><span style="color: #000000;">Follow claims process from submission to clearinghouse and ensure acceptance at payer.</span></li> <li><span style="color: #000000;">Process refunds to insurance companies in accordance with policy.</span></li> <li><span style="color: #000000;">Monitor reimbursement from managed care networks and insurance carriers.</span></li> </ul> <p><span style="color: #000000;"><em>This is a brief overview of job responsibilities and not intended to be all inclusive.</em> </span></p> <p><span style="color: #000000;"><strong>We aim to create a supportive workplace where you are valued, compensated fairly and provided the tools to thrive!</strong></span></p> <p><span style="color: #000000;"><strong>The Carmelite System Can Offer You:</strong></span></p> <ul> <li><span style="color: #000000;">Competitive Compensation</span></li> <li><span style="color: #000000;">Health (Aetna), Dental, Vision, HSA with employer contribution</span></li> <li><span style="color: #000000;">Student Loan Forgiveness Guidance</span></li> <li><span style="color: #000000;">Flexible Spending Account</span></li> <li><span style="color: #000000;">Fully paid Life and Long-Term Disability insurance</span></li> <li><span style="color: #000000;">Benefits available 1<sup>st</sup> of the mo. following 30 days</span></li> <li><span style="color: #000000;">Supplemental insurances</span></li> <li><span style="color: #000000;">Retirement Plan</span></li> <li><span style="color: #000000;">Employee Assistance Program with Discount Marketplace</span></li> <li><span style="color: #000000;">Generous Paid-Time-Off with 11 Holidays</span></li> </ul> <p><span style="color: #000000;"><strong>Please consider joining our team working where <em>The Difference is Love</em></strong>℠<strong>!</strong></span></p> <p><span style="color: #000000;"><em>The Carmelite System, Inc. is an Equal Opportunity Employer and adheres to a policy that prohibits discrimination on the basis of race, color, sex, sexual orientation, gender identity, religion, creed, national or ethnic origin, citizenship status, age, disability, veteran status, and any other legally protected class.</em></span></p> <p><span style="color: #000000;">#CS2024</span></p>

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