Billing Specialist

About Company:

AssuranceJ Homecare Services, Inc. is a premier home health care agency who totally cares for the health and well-being of our clients. As a health care provider, we understand the importance of recovery and quality living of your loved ones. Therefore, our agency offers a prospect of cost-effective and quality services for short-term rehabilitation. The excellent care that is essential to your loved ones’ delicate health condition is what we sincerely provide.

We offer health care programs designed according to the individual needs of our clients. By assessing their specific condition and preferences, we provide services that are extended in a customized way. With the help of our vast resources and professional team of specialists, we are able to meet each of our client’s needs. Serving all sorts of clients regardless of their race, age, gender, status and health condition are what motivates us to continually pursue health care excellence.

To ensure all treatments and procedures are administered as per Plan of Care, our staff members will work directly with your own physician. We also recognize the importance of client’s family and other care providers who are involved in the rehabilitation process. Therefore, we will work hand in hand with them to fully maximize our client’s sure recovery.

At the heart of everything we do lies a commitment to deliver excellence with unwavering assurance and genuine compassion. We believe in upholding the highest standards while remaining deeply connected to the human side of our mission. Whether it’s through innovation, service, or care — our focus is on making a meaningful difference, one experience at a time.

About the Role:

The Healthcare Billing Specialist plays a crucial role in the financial operations of healthcare facilities by ensuring accurate and timely billing for services rendered. This position is responsible for processing medical claims, verifying patient insurance coverage, and ensuring compliance with healthcare regulations. The specialist will work closely with healthcare providers, insurance companies, and patients to resolve billing discrepancies and facilitate smooth payment processes. By maintaining meticulous records and conducting internal audits, the specialist helps to minimize revenue loss and enhance the overall financial health of the organization. Ultimately, the goal of this role is to ensure that healthcare providers are compensated fairly and promptly for their services, thereby supporting the delivery of quality patient care.

Minimum Qualifications:

• High school diploma or equivalent; associate degree in healthcare administration or related field preferred.
• Certification in medical billing and coding (e.g., CPC, CCS, or similar) is recommended.
• Proven experience in medical billing, coding, and insurance claims processing.

Preferred Qualifications:

• Experience with electronic health record (EHR) systems and billing software.
• Knowledge of HCPCS, ICD-10 coding, and internal auditing practices.
• Familiarity with healthcare regulations and compliance standards.

Responsibilities:

• Process and submit medical claims to insurance companies and government payers, ensuring accuracy and compliance with regulations.
• Review and verify patient insurance information, including Medicaid and Medicare coverage, to determine eligibility and benefits.
• Conduct internal audits of billing practices to identify discrepancies and implement corrective actions as needed.
• Communicate with healthcare providers, insurance representatives, and patients to resolve billing issues and answer inquiries.
• Stay updated on changes in medical billing codes, regulations, and payer policies to ensure compliance and optimize revenue cycle management.

Skills:

The required skills in medical billing and coding are essential for accurately processing claims and ensuring compliance with healthcare regulations. Proficiency in HCPCS and ICD-10 coding allows the specialist to categorize services and diagnoses correctly, which is critical for reimbursement. Internal auditing skills are utilized to review billing practices and identify areas for improvement, thereby enhancing the efficiency of the billing process. Knowledge of Medicaid and Medicare billing is vital for navigating the complexities of government payer requirements. Additionally, strong communication skills are necessary for effectively liaising with healthcare providers, insurance companies, and patients to resolve any billing-related issues.