Avalon Health Care Management, Inc. is seeking an experienced Medical Biller for a Medicaid Commercial/Hospice Biller!
The general purpose of the Medicaid Biller is processing and collections of billing Utah, Washington, Arizona, Hawaii, and California Medicaid and Hospice Programs. Includes billing State and Medicaid HMO programs.
If you seek to use your mind and your heart to improve lives on a daily basis, come join our team! We offer great challenges, a rewarding career and opportunities for advancement!
Our Benefits include:
- Medical, Dental, Life, Vision, Short Term Disability, Long Term Disability, and Pet insurance.
- We offer career advancement courses
- Two weeks of PTO
- Review and follow up with the facilities to ensure facility has received authorization to provide services to Medicaid and Hospice patient. Review the TARS, 10A, Award Letters, Managed Medicaid Authorizations.
- Ensure all rates are correct within the billing software. Entry of new Medicaid rates as they are published within the various states.
- Employee will bill according to the outlined billing schedule as set by the Avalon Corporate Office. Billers will prepare, review, and transmit claims using billing software through electronic and paper claim processing.
- Employee will provide claim follow up based on Avalon claim review protocol. Biller will contact Medicaid providers through phone and on-line review of outstanding claims. Follow up process will continue until claims in reduce from outstanding AR.
- Outstanding claims will be researched and reviewed until the AR payer has been relieved. Employee will process refunds and adjustments according to Avalon guidelines.
- Employee will collect the payment EOB and process payment as indicated for patients’ dates of service. Payments which are not equal to outstanding AR will be researched and reprocess for refunds, additional payment request, or adjustment needs.
- Employee will need to have effective communication with the Medicaid and Hospice payers to resolve outstanding issues. Employee will also need to work effectively with facility personal to resolve issues for billing.
- Data entry of ancillary charges within the billing software for month end close.
- Completes monthly aging for facilities and attends aging review meetings when necessary.
- Update cash spreadsheet for Cash Management Department.
- Run collection reports for Cash Management and Operational requests.
- Associates Degree or equivalent work experience.
- Basic understanding of computer technology.
- Proficient in Excel.
- Knowledge of and previous experience with payroll taxes and quarter and year-end adjustments.
- Minimum of 2 years of billing experience.
Avalon Health Care Group is an Equal Opportunity Employer.