BPO Healthcare Senior

Key Responsibilities:

Communicate with clients to address day-to-day information requests and resolve lower-level billing-related issues promptly.

Handle escalated billing responsibilities, including co-insurance, Medicare Part B, therapy filings, and claims for multiple facilities.

Ensure claims compliance with Medicare, Medicaid, and private insurance guidelines while maintaining high accuracy in coding and submissions.

Provide detailed and reliable reports on billing activity.

Act as a Team lead for certain operational tasks, such as monitoring billing performance metrics and assisting with budget management for assigned facilities.

Mentor and support less experienced team members, providing guidance and training on billing practices and policies.

Identify and escalate performance or operational issues to the appropriate leadership for resolution.

Perform additional duties as assigned to meet departmental and client needs

Qualifications:

58 years of billing experience, with a focus on long-term care facilities or healthcare settings preferred.

Advanced knowledge of billing processes, claims management, and payer requirements for Medicare, Medicaid, and private insurance.

Strong organizational skills with the ability to manage multiple priorities and meet deadlines.

Exceptional verbal and written communication skills for interacting with clients and team members at all levels.

Detail-oriented with a high level of accuracy in billing processes and reporting.

Analytical and problem-solving abilities to address a variety of billing scenarios.

Demonstrated ability to handle confidential and sensitive information professionally.

Required Skills and Competencies:

Comprehensive understanding of insurance industries, managed care programs, and government payer guidelines.

Proficiency in billing software and tools for tracking claims and generating reports.

Knowledge of HIPAA regulations and best practices for managing client data securely.

Ability to identify inefficiencies and suggest improvements to enhance operational workflows.