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HCR Home Care Billing Specialist (In-Office) - Rochester, NY in Rochester, New York

Role and Responsibilities

The Billing Specialist position is a member of the Billing Team which reports up through the Finance Department. The Billing Specialist is responsible for bill file routing, uploading, error correction, and re-submission.

Essential Functions

  • Responsible for submitting and receiving all electronic claim files and payer response/rejection files, and for researching and re-submission of claims rejected by clearing house/payer.

  • Work pre-post reports prior to submission to ensure claims are correct.

  • Initiate and complete enrollment process for payers/providers in medical clearing house.

  • Assist in adding and maintaining the HCHB payer setup process.

  • Support, maintain, and administer multiple data systems for commercial insurances.

  • Daily mapping, testing, processing, monitoring, logistics/order processing support, and reporting.

  • Collaborate with manager and Billing Team to help complete billing claim workflows.

  • Use appropriate documentation, reference materials, and/or websites to ensure that billing claims are processed accurately and efficiently.

  • Monitor the number and types of claim rejections; resolve and report issues to Revenue Cycle Manager in order to ensure every service is billed accurately and timely.

  • Assist in the development of a Billing Manual.

  • Produce high quality work that is complete and accurate.

  • Other duties as assigned.

This job description reflects managements assignment of essential functions; and nothing in this herein restricts managements right to assign or reassign duties and responsibilities to this job at any time.

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