Medical Billing Collections Specialist
We are seeking a detail-oriented Medical Billing Collections Specialist to join our team and ensure accurate and timely management of claims for Skilled Nursing Facility services. As a key contributor to the revenue cycle, you'll handle critical tasks such as claims submission, denials management, and appeals, while ensuring compliance with Medicare, Medi-Cal, and other insurance guidelines.
Key Responsibilities :
- Claims Submission : Accurately and promptly prepare and submit claims to insurance payers for Skilled Nursing Facility services.
- Denials Management : Review denied claims, identify root causes, and implement corrective actions to minimize future denials.
- Appeals : Draft and submit effective appeals for claim denials to secure appropriate reimbursements.
- Billing Accuracy : Maintain detailed, accurate patient records, ensuring compliance with Medicare, Medi-Cal, and payer-specific requirements.
- Follow-Up : Communicate with insurance companies and other payers to resolve outstanding claims and secure timely reimbursements.
- Regulatory Compliance : Stay informed and ensure adherence to all federal, state, and local billing regulations, including compliance with HIPAA.
- Collaboration : Work closely with administrative and clinical teams to optimize billing workflows and integrate documentation processes.
- Reporting : Generate clear, actionable account reports showing billing trends, claim statuses, and resolution timelines for management review.
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