About Us::
A pioneer in the caregiving space, Careforth supports family caregivers across the United States to confidently care for their loved ones at home. Through a combination of in-person home visits, remote coaching and our proprietary digital collaboration app, we provide caregivers with support, guidance, confidence, and connection to resources they need. The Caregivers and families we support stay with Careforth for many years, building lasting relationships along the way. Join us today and live our values: lead with heart, cultivate trust, go beyond.
Position Summary::
Reporting to the Director of Healthcare Revenue Cycle Management, the Medical Billing Analyst will handle all functions related to the collection of necessary claim documentation, claim submission, collections, and follow through on outstanding claims and cash applications; all actions relating to delinquent accounts, special adjustments, and/or write-offs. This individual will lead meetings with the management team from each state Careforth does business in regarding consumer liability accounts and will demonstrate strong knowledge of the team’s core processes and functions.
What You Will Do::
- Collect all the information necessary to work with insurance claims; Ensure patient demographic and insurance information is input correctly into the billing system
- Analyze all billing procedures and identify opportunities for improvement.
- Preparing reports and analysis to identify the systemic root causes of the claims not being paid by meeting billing deadlines.
- Lead meetings with state management teams regarding consumer liability accounts; resolve issues as needed
- Monitor, track, and report on self-pay balances using software applications, identify issues, and recommend necessary actions as needed
- Handle the 837P claim file process from start to finish, including reviewing the 999 file
- Research, correct, and re-submit rejected and denied claims
- Post 835 payment files to the billing system and manually edit any unmatched payments to post
- Research, administer, and resolve any billing discrepancies; resubmit rejected and denied claims if necessary, working with payers to resolve outstanding claims issues as needed
- Audit files submitted by running various reports to ensure no variances exist; Inform the management team of any issues
- Ensuring consumer's billing accounts are set up correctly and according to their requirements.
- Perform other duties as assigned
What You Will Bring::
- 3+ years experience working in the medical billing field
- Knowledge/experience working with billing and payment cycles for medical accounts and analyzing accounts receivable reports required
- Strong data entry skills required; Attention to detail and ability to prioritize
- Knowledge of insurance processes and terminology, including an understanding of how EOBs, copays, coinsurance, deductibles, spenddowns, denial codes, and how cost shares work
- Experience working with Medicaid, private insurance, insurance verification, authorization and reimbursement is a must
- Strong organizational, problem solving, communication (i.e. verbal, non-verbal) and analytical skills
- Strong skills in MS Office (Word, Excel) and medical billing software; Ability to manipulate spreadsheets as needed
- Experience workikng in Provisions is an asset
- Ability to multi-task in a changing and fast paced environment
Join Our Award Winning Team:
Founded in Boston, Careforth's caregiver programs and services improve health outcomes, keeping care at home longer. Additionally, our programs provide financial benefit to caregivers and cost savings to state agencies and health plans. At Careforth, we understand the challenges of caregiving and are committed to supporting family caregivers at every turn.
Caregivers play a critical role in the future of healthcare—and so can you.
# LI-REMOTE with the exception of the following states: CA, CO, NY
Apply now!
For more information, please visit www.Careforth.com.
Careforth is an Equal Opportunity Employer*
DISCLAIMER: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.
Careforth supports families with diverse backgrounds and as an equal opportunity employer, we seek employees who reflect the diverse population we serve. Careforth complies with all applicable laws concerning hiring and employment practices and is firmly committed to fostering and maintaining a workplace free from discrimination. We pledge to hire, train, and promote our employees without regard to race, religion, gender, gender identity, genetic information, age, national origin, sexual orientation, disability, veteran status, or any other category protected by applicable law.
Careforth strives to create experiences that are accessible and welcoming to everyone, including making www.careforth.com and the careers site accessible to any and all users. If you would like to contact us regarding the company’s diversity, equity and inclusion initiatives, inquire about a specific accessibility need or the accessibility of our website, or if you need assistance completing an application process, please contact People & Culture at 866-797-2333.