Revenue Payor Specialist - Viemed Healthcare : Job Details

Essential Job Responsibilities:

* Evaluate new and existing payers/networks and their fee schedule for participation.

* Proactively monitors payor medical policy updates and ensures those are applied to daily processes.

* Collaborates with revenue and credentialing on enrollment of NPI's for EDI submissions and imports of ERNs into billing software.

* Inputs all new insurance payors contracted/non-contracted in billing software.

* Ensures operations are conducted in a manner that is consistent with overall department protocol, and in compliance with Federal, State, and payer regulations, guidelines, and requirements.

* Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.

* Reports all concerns or issues directly to Director of Revenue.

Experience:

* Minimum of four (5) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system, with a deep understanding of insurance medical/fee schedule policies and regulations experience preferred.

Knowledge/Abilities:

* Strong knowledge of payor reimbursement and medical policies

* Strong excel, analytical, problem-solving, and communication skills.

* Detailed-oriented with the ability to work independently and meet deadlines.

* Working knowledge of CPT and ICD9 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes.

* Up to date with health information technologies and applications.

* Must be proficient in Microsoft Office, including Outlook, Word, and Excel.

* Ability to communicate effectively in writing, over the telephone, and in person.

Work Environment:

* Position is in well-lighted office environment. Occasional evening and weekend work may be required.