Quality Assurance Engineer
Incubate Labs Pvt Ltd
Job type full-time part-time
Full job description
Healthteq services, llc is a customer-focused, premier revenue cycle management partner with over a decade of experience & resources in delighting customersWe guarantee quality services along with a good return on investment with our revenue cycle management solutionsOur approach is built on a proven holistic operating model designed to fit seamlessly into your organizationContact us today to see how we can enhance revenue for your practice.
3 to 5 years of recent skilled nursing facility billing experience
Medicare and medicaid snf billing experience required
Experience working with aht preferred but not required
Knowledge of working snf denials both on the front and back end of the billing process
Knowledge of stay authorization processes.
Experience in cpt and icd-10 coding
Familiarity with medical terminology
Ability to communicate with various insurance payers
Experience in filing claim appeals with insurance companies to ensure maximum reimbursement
Responsible use of confidential information
Strong written and verbal skills
Ability to multi-task
Ensure all claims are submitted daily with a goal of zero errors
Timely follow up on insurance claim status
Reading and interpreting an eob (explanation of benefits)
Respond to inquiries by insurance companies
Meet with billing manager/supervisor to discuss and resolve reimbursement issues or billing obstacles
Any additional duties as requested by management
Knowledge with in and out of network insurances, workers compensation, insurance verification, patient responsibility, and process for prior authorization.
Knowledge of interpreting eobs, posting payments, and adjusting accounts appropriately.
Familiarity with icd-10 and cpt codes and procedures.
Proficient in medical coding guidelines and regulations.
Reviews medical record documentation to identify pertinent diagnoses and/or procedures that require coding;
Reviews medical records to assure accurate specificity of diagnoses, procedures, and appropriate reimbursement for professional charges
Effectively utilizes icd 10, cpt, hpcps, modifiers and/or other codes according to coding guidelines;
Communicates effectively with provider and/or all appropriate parties regarding missing information such as cpt, diagnoses codes, documents, operative reports, etcIn order to ensure proper coding;
Increases revenue by collecting payments on outstanding accounts;
Conducts audits and coding reviews to ensure all documentation is accurate and precise;
Manage the status of accounts and identify inconsistencies;
Maintain appeal/denialsEnsure we are completing timely.
This is a telecommute/work from home position.