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Billing Claims Specialist in Springfield, MO at Netsmart

Date Posted: 12/4/2018

Job Snapshot

Job Description


We're growing and looking for Billing Claims Specialist to join our team!  This position is responsible for posting, collecting, and managing accounts. They are responsible for submitting a claim, posting payments & adjustments, rebills, Electronic Claims Submission, following up with insurance companies, reconciling accounts, daily balancing controls & reporting, the patient statement process, and preparing monthly reports.


  • Prepares and submits clean claims to various insurance companies either electronically or by paper.
  • Posts payments, adjustments, transfer of responsibility and refunds, as necessary
  • Issues adjusted, corrected, and/or rebilled claims to insurance companies.
  • Denial and insurance follow-up management
  • Insurance Appeal Process
  • Handling patient inquiries.
  • Answers questions from clerical staff and insurance companies.
  • Identifies and resolves patient billing problems.
  • Prepares, reviews, and sends patient statements to mailing service.
  • Reviews accounts and make recommendations to the Senior Claims Billing Specialist regarding non-collectible accounts.
  • Performs dialing collection actions including contacting insurance company, contacting site, correcting and resubmitting claims to third party payers.
  • Prepares and posts daily deposits received from customer site (P.O. Box) and/or lockbox remittance.
  • Processes payments and denials from insurance company either electronically or manually.
  • Participates in educational activities.
  • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations

Job Requirements:

  • Medicare Home Health and Hospice: billing, payments and denial management experience
  • Medicaid and Commercial Home Health and Hospice: billing, payments and denial management experience
  • Experience with medical billing system: Homecare Advisor and Hospice Advisor software system
  • Knowledge of billing / collection practices preferred
  • Strong keyboard skills.
  • Works well in environment with firm deadlines; results oriented.
  • Perform multiple tasks effectively.
  • Able to work both independently and as part of a team.
  • Strong analytical skills required.
  • Capable of making timely, independent decisions.
  • Excellent oral, written, and interpersonal communications skill
  • Previous medical billing experience along with knowledge of billing related reporting; 1+ years’ experience in health-care billing & collection practices
  • Experience with Medicaid’s State Eligibility Systems (various states)
  • Excellent organizational skills
  • Proficiency in Microsoft Office Suite

Netsmart provides equal employment and advancement opportunities to all individuals. Employment decisions at Netsmart will be based on performance, qualifications, abilities, education and experience.  Netsmart does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, physical or mental disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state and local laws. Netsmart complies with any applicable state and local laws governing nondiscrimination in employment.