Reimbursement Coordinator - HMO Billing, SNF

Posted 4 Hours Ago
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Hiring Remotely in United States of America
Remote
Junior
Healthtech • Professional Services • Software
The Role
The HMO Billing Specialist will manage claims for a Skilled Nursing Facility, handling billing information, performing quality assurance on charges, submitting claims to insurance companies, and following up on claim statuses. This role requires effective time management and attention to detail, focusing on denied claims and their resolutions.
Summary Generated by Built In

Corridor, powered by WellSky, is a market leading provider of revenue cycle management (RCM) solutions to Skilled Nursing Facilities (SNFs). We have a holistic approach to accounts receivable that encompasses every aspect of A/R management, from the point of admission to collections.

We are currently seeking a full-time HMO Billing Specialist to join our Comprehensive team. This role involves independently researching and identifying claim issues, demanding a sense of urgency and the capacity to manage a high volume of claims.

The ideal candidate will have strong communication and interpersonal skills, proficiency in Microsoft Office, acute attention to detail in various scenarios, effective time management, deadline orientation, and perseverance. If this description aligns with your skills, we invite you to apply today!

A day in the life!

You will be responsible for the following:

  • Obtaining billing information from clients to generate claims
  • Performing QA of charges received and making modifications/changes to product a clean claim
  • Tracking pending claims
  • Submitting claims to insurance companies in a timely fashion and within the individual insurance company’s timely filing period
  • Obtaining claim status by calling the payer and/or using an online claims status system
  • Researching claim payments, partial payments, over payments
  • Focusing on all denied/partially paid claims until full payment is received
  • Working in a time-efficient manner to cover all denied claim from assigned homes
  • Knowing when to forward a case to the biller/tracker
  • Understanding how the higher dollar balances impact our collection rate and focus
  • Prioritizing the “clean up” of balances by writing off rates/NAMI's/other adjustments

Do you have what it takes?

Required Qualifications:

  • 1-2 years related work experience

#LI-KL2

#LI-Remote

Additional job expectations applicable to this position include:

  • Willingness to work additional or irregular hours as needed
  • Working in accordance with corporate and organizational security policies and procedures
  • Performing other responsibilities as assigned

WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference.

WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace.

 

Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.

 

Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky:

  • Excellent medical, dental, and vision benefits
  • Mental health benefits through TelaDoc
  • Prescription drug coverage
  • Generous paid time off, plus 13 paid holidays
  • Paid parental leave
  • 100% vested 401(K) retirement plans
  • Educational assistance up to $2500 per year

Top Skills

MS Office
The Company
HQ: Overland Park, KS
1,069 Employees
On-site Workplace
Year Founded: 1980

What We Do

WellSky is a technology company advancing human wellness worldwide. Our software and professional services address the continuum of health and social care — helping businesses, organizations, and communities solve tough challenges, improve collaboration for growth, and achieve better outcomes through predictive insights that only WellSky solutions can provide.

WellSky serves more than 20,000 client sites around the world — including the largest hospital systems, blood banks and labs, home health and hospice franchises, government agencies, and human services organizations.

Informed by 40 years of providing software and expertise, WellSky anticipates providers’ needs and innovates relentlessly to help people thrive. Our purpose is to empower care heroes with technology for good, so that together, we can realize care’s potential and maintain a healthy, flourishing world.

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