Billing Analyst II

Job Title 

Location

Additional Location(s)

Employee Type

Working Hours Per Week

SUMMARY

Support Billing management to ensure timely and correct claims are filed with all respective payers and intermediaries. Monitor claims for timely processing of payments and rejections and work A/R every week.

BILLING ANALYST RESPONSIBILITIES

include the following. Other duties may be assigned as necessary.
• Perform claim audit review for Medicare and PDGM Medicare Commercial
• Make daily RAP/NOA and EOE submissions to the state for all payers
• Work the Medicare/Medicare PDGM Claims Held workflow
• Process Oasis reports
• Review unbilled reports for Medicare and Non-Medicare on a weekly basis
• Bill Medicare/Non-Medicare claims on a daily basis
• Work daily NOA's at Risk Report
• Review your pre-post report to verify all visits have a usual and customary rate and contractual adjustment on a bi-weekly basis
• Work Medicare/Non-Medicare claim rejections
• Perform billing note entry on all outstanding accounts over 30 days
• Make insurance calls to check status on outstanding claims
• Process requests for additional information from insurance companies
• Answer billing queue calls
• Collect patient payments via the phone
• Work monthly Medicare, Medicare HMO and 3rd party agencies
• Review Monthly SOX report to ensure every account over 30 days has a Billing note
• Payer changes
• Cover department when other employees are ill or on vacation
• Duties may vary depending on the insurance team the employee is on
• Comply with Company’s Core Values and Core Competencies
• Perform other duties as assigned by supervisor

BILLING ANALYST REQUIREMENTS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• High school education or equivalent, associate degree preferred
• Minimum of one to five years billing experience (in home health care)
• Proficiency in Microsoft Office Suite
• Knowledge of HCHB, Esolutions, Waystar, and commercial web portals
• Knowledge of Medicare FSSO DDE software
• Strong computer knowledge
• Demonstrated patience, flexibility, and cooperative attitude
• Strong communication skills with other office staff
• Conscientiousness and attention to detail

CERTIFICATES, LICENSES, REGISTRATIONS

Must have and maintain in good standing professional license, certificate, or registration, as applicable.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.

COMMENTS

This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.

About Graham Healthcare Group:

As an innovator in an evolving healthcare world, Graham Healthcare Group has been designing business and technology solutions to drive better care, outcomes, and productivity within its own home health and hospice companies for over 20 years. In the last several years, our solutions have been successfully integrated across the healthcare continuum.

Join the Graham Healthcare Group and enjoy the following benefits:

• Competitive Pay:  With opportunity for advancement 

• Health and Welfare Benefits:  Various medical, dental, and vision insurance options for you and your family to choose from. 

• Supplemental Benefits: Company paid life insurance and disability benefits.  Also, pre-tax FSA and HSA plans are offered. 

• Generous PTO Packages.

• Retirement:  Save for your future with our company offered 401k plan and pension.

• Company-Paid Education Programs:  Grow your career by taking advantage of 50% discounts on tuition for selected courses offered by Purdue and Kaplan. 

Benefits may vary based on your employment status.

NOTICE:

• Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.
• By supplying your phone number, you agree to receive communication via phone or text.
• By submitting your application, you are confirming that you are legally authorized to work in the United States.

Graham Healthcare Group is an Equal Opportunity Employer