Culture Vision at Consumer Direct Care Network
At CDCN, we strive to create a workplace where everyone is supported and motivated to be their best; we collaborate on shared goals and celebrate our accomplishments.
JOB SUMMARY
Billing Analysts are responsible for the creation, payment processing, and reconciliation of all claims submitted to payers on behalf of CDCN. They ensure that all claims for payment are submitted by the timely filing deadlines of the payers, that payments received are applied as efficiently as possible, and that adjustments and denials are handled within the timely filing requirements of each individual payer contract. They attain and use an understanding of invoicing and payment processing to work out any potential claim issues and outstanding balances.
JOB DUTIES
- Work with multiple computer systems (Excel, Office, Solomon, and Docuware) to process payments to ensure Consumer Direct Care Network receives payments for the care provided to our caregivers and members
- Create claims and bill payers for reimbursement of the services provided
- Post and reconcile payments
- Effectively communicate verbally and in writing
- Comply with applicable legal requirements, standards, policies, and procedures
- Demonstrate dependability
- Demonstrate effective problem-solving and decision-making skills
- Exhibit computer efficiency
- Maintain necessary skills and knowledge to coordinate workflow
- Participate in professional development and training activities
- Prioritize and multitask effectively
- Prepare claims and bill payers for services provided by assigned programs and states
- Resubmit claims for payment when necessary according to procedures and processes specific to each payer
- Engage in and facilitate positive and cohesive team environments
- Record denial, short pay, and pending notes in the appropriate format
- Process and reconcile claims payments
- Ensure claims are received and accepted by the payer
- Develop skills to communicate directly with the payer and program office when needed
- Basic understanding of aged receivables and the ability to execute the basic steps necessary to resolve nonpayment such as: Identifying items nearest timely filling researching and correcting errors Expediting rebilling Document actions
- Other duties as assigned
QUALIFICATIONS
- Microsoft Office experience preferred
- High School Diploma preferred
- Prior office experience preferred
- Prior medical billing experience preferred
- If remote, employee must provide their own reliable internet service
- Be able to successfully pass a background screening
The incumbent typically works in an office environment and uses a computer, telephone, and other office equipment as needed to perform duties. The noise level in the work environment is typical of that of an office. Incumbents may encounter frequent interruptions throughout the workday. The employee is regularly required to sit, talk, or hear; frequently required to use repetitive hand motion, handle or feel, and to stand, walk, reach, bend or lift up to 20 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.