Sarnova is an Equal Opportunity Employer. Our mission is to be the best partner for those who save and improve patients’ lives. Excellence in delivering upon our mission is dependent upon having a diverse team that is empowered to bring their full, authentic self to work each day. We strive to create a workplace that reflects the communities we serve, and we are passionate about creating an inclusive workplace that promotes and values diversity.
Billing Specialist
Location
United States
Posted
2 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Billing Specialist
Sarnova
Role Description The Billing Specialist I will utilize master billing guides and other process instructions to review PCR to ensure medical necessity, reasonableness, level of service, ICD10 coding and mileage is correct. This role is fundamental in Digitech's revenue cycle management process and ensures that claims are coded and billed accurately and timely. The selected Billing Specialist I will maintain a strong working knowledge of billing rules and regulations for all payor types in the various regions for which they process claims. - Review patient medical records and supporting documentation - Add required data elements to the account in the billing platform, including ICD-9 codes, charges, and billing narratives - Ensure all tasks are completed in accordance with Quick Med Claims policies as well as state and federal guidelines - Meet or exceed defined productivity standards for the position - Properly notate accounts reviewed - Attach necessary documentation within the system or to paper 1500s - Obtain additional information from clients when needed, such as HIPAA forms, pre-authorizations from insurance companies, and physician medical necessity forms, in order to submit third-party claims - Review billing documents in the billing platform using dates provided on patient care reports, physician medical necessity forms, and hospital face sheets - Review and validate claims electronically or on paper - Monitor tags or workflows to ensure timely validation of claims - Process all insurance claim forms in accordance with federal and state laws as well as departmental procedures - Provide accurate billing in compliance with regulatory requirements and internal policies and procedures - Demonstrate biller competency by achieving and maintaining billing accuracy scores that meet or exceed expectations during quality assurance and audit activities - Adhere to all Digitech HIPAA privacy policies and procedures, maintaining the confidentiality and security of sensitive patient information - Additional job duties as assigned Qualifications - High School Diploma or equivalent - 1 – 2 years of Medical billing preferred - Certified Ambulance Coder (CAC) preferred - Demonstrated ability or willingness to attain QMC Biller Certification upon employment - Must be able to type 35 wpm - Basic computer skills including ability to utilize multiple windows and programs simultaneously - Customer service oriented - Attention to detail and focus on quality - Organizational skills - Must display sufficient written and oral communication skills - Must have the ability to work in a fast-paced environment - Must have the ability to work with minimal supervision - Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment Benefits - Competitive salary, commensurate with experience - Comprehensive benefits package, including 401(k) Plan
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Guardian Pharmacy ServicesGuardian Pharmacy Services is a company in the healthcare space self-described as one of America’s largest institutional pharmacy companies and one of Georgia
Title: Billing Specialist, Pharmacy Location: Jacksonville, Florida, USA Work Arrangement: Hybrid Potential Job Type: Full-time Job Description: Extraordinary Care. Extraordinary Careers. With one of the nation’s largest and most innovative long-term care pharmacy services providers, there is no limit to the growth of your career. Guardian Pharmacy of Jacksonville, a member of the Guardian family of pharmacies, has an exciting opportunity for you to join our rapidly growing team in Jacksonville, Florida. Why Guardian Pharmacy of Jacksonville? We’re reimagining medication management and transforming care. Who We Are and What We’re About: Our core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered. We offer an opportunity to learn and grow your career in a fast-paced, diverse, and inclusive environment. If you are looking for a challenging, team-oriented environment in which you can put your expertise to work, then this is the place for you. Schedule: M-F rotating schedule between 10:30 am -7 pm, weekend rotation; Hybrid Potential; Pharmacy in Jacksonville, FL. - During training, the schedule is 9 am-5:30 pm until independence. This would likely last about 90-120 days. - Position will require 1 weekend shift every 3 weeks, rotating. Will work both Saturday and Sunday on their scheduled weekend. The candidate may be asked to cover other varying shifts if a coworker is off on vacation. - Will require a Florida state pharmacy tech license, and Frameworks experience is a plus. Responsible for processing customer bills and insurance claims in an accurate and timely manner. This includes assisting with all daily and month-end billing functions, procedures and reporting. Provides excellent customer service to patients, caregivers, medical providers and insurance carriers. ATTRIBUTES REQUIRED: - Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy - Relational – ability to build relationships with business unit management and become “trusted advisor.” - Strategy and Planning – ability to think ahead, plan and manage time efficiently. - Problem Solving – ability to analyze causes and solve problems at functional level. - Team Oriented – ability to work effectively and collaboratively with all team members. ESSENTIAL JOB FUNCTIONS (include the following): - Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities. Reverify benefit coverage criteria as needed for claims follow up. Accurately enters and/or updates patient/insurance information into billing system. - Maintain and continually audit patient files and corresponding documentation necessary to defend third party audits and ensure payer and company compliance. Accurately enter patient information into the pharmacy system. - Provide assistance and timely response to all billing customer inquiries via phone or electronic communications. Research and resolve patient billing issues regarding insurance eligibility, coverage, and related benefits. - Provide guidance and support to resident or responsible party by running Medicare plan comparisons during open enrollment and special enrollment periods. Proactively review patient profiles, drug regimens and insurance coverage to evaluate options to save resident money. - Responsible for completion of daily census, admit, discharge, and room changes for the facilities assigned. - Process patient payments, returns, and credits. Transmit individual credit card payments as needed. - May pursue payment from delinquent accounts and make payment arrangements. - Research, identify and organize requested audit documentation in timely manner. - Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as needed. Make corrections as needed and rebill claims as necessary. - Develop knowledge and understanding in pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances) - Develop proficiency in the utilization of pharmacy information systems to meet operational needs and regulatory requirements. This includes using pharmacy systems to process prior authorizations, resolve rejections, produce various reports as necessary, and complete billing functions. - Rotate through other departments to gain working/functional knowledge of other department workflows. - Follow all applicable government regulations including HIPAA. - Work as a collaborative team member to meet the service goals of the pharmacy. - Other essential functions and duties may be assigned as needed. EDUCATION AND/OR CERTIFICATIONS: - High School Diploma or GED required. - Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB) may be required (pharmacy specific). SKILLS AND QUALIFICATIONS: - 1+ years of related experience - Advanced computer skills; pharmacy information system experience preferred. - Ability to work independently and deliver to deadlines. - Great attention to detail and accuracy - Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines - Quality-minded; motivated to seek out errors and inquire about inaccuracies. WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the job. - The noise level in the work environment is usually low to moderate. - Due to the collaborative nature of the business and the need to service customers, the employee must be able to interact effectively with others in an office environment, manage conflict, and handle stressful situations and deadlines. - Requires desk work in office environment. - Ability to work flexible hours. What We Offer: Guardian provides employees with a comprehensive Total Rewards package, supporting our core value of, “Treat others as you would like to be treated.” Compensation & Financial - Competitive pay - 401(k) with company match Family, Health & Insurance Benefits (Full-Time employees working 30+ hours/week only) - Medical, Dental and Vision - Health Savings Accounts and Flexible Spending Accounts - Company-paid Basic Life and Accidental Death & Dismemberment - Company-paid Long-Term Disability and optional Short-Term Disability - Voluntary Employee and Dependent Life, Accident and Critical Illness - Dependent Care Flexible Spending Accounts Wellbeing - Employee Assistance Program (EAP) - Guardian Angels (Employee assistance fund) Time Off - Paid holidays and sick days - Generous vacation benefits based on years of service The Guardian Difference Our clients require pharmacy services that aren’t “cookie cutter.” That’s why every Guardian pharmacy is locally operated and empowered with the autonomy to tailor their business to meet their clients’ needs. Our corporate support offices, based in Atlanta, Ga., provide services such as human resources, business intelligence, legal, and marketing to promote the success of each Guardian location. Regardless of your role at Guardian, your voice and talents matter. Because healthcare is an ever-changing industry, we encourage innovative thinking, intellectual curiosity, and diverse viewpoints to ensure we stay competitive in today’s dynamic business environment. At Guardian, we are dedicated to fostering and advancing a diverse and inclusive workforce. Join us to discover what your best work truly looks like
Role Description Impact Property Solutions is searching for a Warehouse Billing Clerk to act as the company’s voice and face as well as lead our amazing team of customer service reps. This role will schedule installations, resolve emergency issues, provide training for new employees, and handle service issues beyond agent capability. The position also requires excellent interpersonal skills, problem solving and conflict-resolution skills. - Enter flooring and manufactured good selections into computer database within 24-48 hours of receipt. - Assist with billing administration. - Adjust and close orders for sub-contractors to ensure accurate payroll. - Answer phone calls throughout the day and make sure flooring installer’s inquiries are being answered in a timely manner. - Enter revisions and or changes and delete old selections when applicable. - Resolve problems related to correct data entry procedures. - Continuously email and call sales department for approvals and notate any add on to order and file order. Qualifications - High School Diploma or GED Equivalent - Minimum 1 year of administrative or general office experience. - Minimum 1 year of clerical experience. - Able to work remotely at home equipped with high-speed Internet Service - Associates degree - Billing administrative experience - RFMS Systems Experience is a plus Requirements - Excellent communication skills (written & verbal) - Must be detail-oriented and pay close attention to accuracy. - Proficiency with MS Office products, including MS Outlook, Excel and Word. - Strong strategic thinking skills. - Ability to prioritize work and manage time effectively. - Proactive problem-solving ability. - Excellent verbal and written communication skills. - Excellent concentration Benefits - Competitive Health Insurance Plans - Vision and Dental Plan - Company paid life insurance. - Generous Paid Time Off Program - 401(K) / Roth plan with employer match - Generous PTO plus paid Holidays Physical Requirements - Prolonged periods of sitting at a desk and working on a computer. - Must be able to lift to 25 pounds at times.
• Assist with preparing and completing monthly billing for DCS-related client services. • Review service documentation to confirm billing accuracy before submission. • Ensure all billable services are captured so the agency is paid for services performed. • Upload required documents into billing systems, software platforms, and/or designated folders. • Follow strict billing timelines with a strong sense of urgency. • Upload large volumes of client-related documents with accuracy and consistency. • Ensure documents are named, saved, categorized, and uploaded according to company standards. • Review uploaded files to confirm accuracy, completeness, and correct placement. • Maintain organized electronic records for billing and audit purposes. • Conduct routine audits of billing documentation, client records, and service files. • Identify missing, incomplete, inaccurate, or inconsistent information. • Compare documentation across spreadsheets, billing systems, and internal software. • Flag discrepancies and follow up with the appropriate internal team member. • Help ensure the organization is prepared for audits and compliance reviews. • Use spreadsheets to track billing status, missing documents, client information, and audit findings. • Enter and update data accurately. • Use filters, sorting, basic formulas, and organized tracking systems to manage high-volume information. • Maintain confidentiality and accuracy when working with sensitive client and billing information. • Communicate clearly and professionally with U.S.-based team members. • Provide updates on billing progress, missing documents, and urgent issues. • Ask clarifying questions when documentation is incomplete or unclear. • Escalate concerns quickly when deadlines or billing accuracy may be impacted.
Concentra Support Specialist I
ConcentraConcentra is an Equal Opportunity Employer M/F/Disability/Veteran. Concentra is committed to protect patient data and to ensure privacy of personal and medical information. Every Concentra colleague has the responsibility to adhere to data protection principles. If a colleague's role includes handling or processing sensitive data, role-specific policies and requirements apply to ensure the protection of patient information.
Role Description The Support Specialist I provides first level assessment, support, and resolutions. This position is responsible for delivering quality customer service and handling daily support requests for our colleagues received via phone calls, chat, or self-service incidents. Additionally, the Support Specialist escalates any unresolved issues to ensure a timely resolution. Responsibilities - Collect appropriate and accurate information while handling support incidents, including logging, follow up, updating and closing of incidents, tasks or chats assigned. 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Qualifications - High School Diploma required; College Degree preferred. - In lieu of undergraduate degree, the ratio is 1:1 meaning one year of college equals one year of work experience and vice versa. - Customarily has at least 6 months of large-scale multi-site IS operations experience. - PC Hardware and peripheral experience preferred. - Knowledge of Microsoft productivity applications preferred. - Knowledge of browser-based technology a plus. - Understanding of operating systems such as Windows and OS X/iOS a plus. - Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility. - Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism. - The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies. - Strong interpersonal and communication skills a must. - Effective communication skills. Ability to read, write, and speak in a professional manner. - Excellent analytical and problem-solving skills are essential. - Ability to effectively multi-task and adapt to changing business priorities. - Ability to work with minimal direction. - Must possess a personal sense of urgency. - Excellent time management and organizational skills are required. - Excellent listening skills and attention to detail. - Ability to think outside the box. Requirements - The physical demands described here represent those that an employee must meet to perform the essential functions of this job successfully. Reasonable accommodations may enable individuals with disabilities to perform the essential functions. - While performing the duties of this job, the employee is continuously sitting for extended periods, occasionally standing and walking. - May occasionally utilize hands and fingers and continuous flexing or extending wrist to perform job-related tasks. - Occasional stooping, pushing, pulling, kneeling, reaching, or overhead reaching, climbing, and frequent repetitive motion in the performance of work. - The ability to hear and understand with clarity, detect sound, and have conversations with staff, customers, management, etc. - Normal or corrected vision to acceptable levels for office work. - The ability to lift/carry up to 10 pounds. - Work is performed primarily in the office/field (remote) environment. - Involves frequent contact with clients, other sales staff, and management. - Position requires flexibility in working hours. - Must be able to effectively resolve conflicts as they arise. - The mental demands described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. - In this position, the employee may have imposed pressure on a routine and frequent basis to meet various deadlines, contact with people in stressful and unpredictable situations and to handle confidential and sensitive information and situations with care. Travel - Minimal (may include overnight) travel up to 10% by land or air is required of employee in this position. - While traveling the employee may encounter varying weather conditions, road and walking surfaces and will need to adjust to those conditions (i.e., inclement weather, slippery surfaces, wet surfaces, uneven surfaces, humid, cold or hot temperatures, etc.). - Also, while traveling the employee will need to adjust to the physical demands that may include: lifting to place luggage in overhead bin(s), standing in line(s), walking, sitting for unknown periods of time, and other physical demands that traveling may impose on a person. Company Description Concentra provides equal employment and affirmative action opportunities to applicants and employees without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, pregnancy, protected veteran status, disability, or other protected categories. In addition, Concentra Inc. complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities.


