QSM Health Systems, Inc
Billing & Coding Specialist (Finance)
Posting weekly charges
Transmitting clean claims
Audit all claims billed prior to transmission to Medicare and other payers
Correct claims that have not been able to pass through the portal due to clerical and / or computer errors
Resubmit any denied claims for reconsideration
Secondary responsibilities:
Assist Referral Coordinator with daily face sheets from facilities and notify providers of new patients
Support and aid Collections Department with outstanding claims when needed
Prepare notes for ADR's and submission to fiscal intermediaries
Assist in preparing letter/notes for ALJ hearings as needed
General responsibilities:
Handles incoming calls from physicians, skilled nursing facilities, and managed care organizations
Obtains approval for "facility-pay" or pro-bono care from the COO.
Comply with all departmental policies and procedures.
Participate in departmental and company in-services as appropriate.
Perform other duties as assigned by Operations Manager.
Emphasis will be on compliance with procedures and protocol, internal controls, and maintaining the highest level of workplace behavior. Must be able to communicate well telephonically.