22nd Century Technologies Inc.
22nd Century Technologies Inc.
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Title:
Medical Coder/Healthcare Billing Specialist
Company: State of NJ
Pay Rate: $29.09 / Hour (W2, no benefits)
Duration: 6+ months
Location: Paramus, NJ 07652
Work Hours: 8 AM – 4:30 PM; Lunch: 30 min Break (unpaid); Work from office or remote: office
Dress Code: Casual Formal
Parking: Yes
Job Description
Equipment : Computer
Computer software : MS Office; Accounting Software
Interview Mode : Personal
Required skills/education : Proficient with MS Office (Word, Excel); Reporting; Creating Memos
Certification : Medicare Part A
Primary duties : Responsible to obtain reimbursement from Medicare and private insurance companies for skilled nursing care; establish cost for medical services; calculate rate for each level of care based on Medicare Fee Schedule.
Process Part A claims in compliance with Medicare guidelines and NJ Administrative Code for Veterans Homes; review, interpret and implement rules, regulations, policies and procedures regarding Medicare billing.
Attend weekly meetings with MDS Coordinator and Rehab Program Manager to review residents' level of care and current billing status (UR Meeting).
Determine SNF days available; project when the patient will exhaust benefits; determine when a resident is entitled to a new benefit period; change resident care level from private to Medicare; update resident's reimbursement to reflect Medicare as primary payer; verify qualifying hospital stay.
Implement appropriate medical coding; apply to UB‑04 form required by Medicare and private insurance companies for proper reimbursement.
Verify accuracy of ICD‑10 Codes prior to claims submission (Triple Check Meeting).
Receive PDPM classification model from nursing department and calculate rates according to Medicare Fee Schedule for each claim.
Provide ancillary vendors with Medicare Part A Census Report; determine accurate charges for ancillary vendors by reconciling invoices and calculating rates according to Medicare Fee Schedule.
Calculate charges and create electronic file for submission to Medicare.
Process Commercial Claims: submit claims to private insurance companies to obtain reimbursement for services provided to residents with Medicare replacement plans.
Utilize Inovalon (Ability Network) to edit, track and adjust claims.
Analyze Medicare remittance advice and reconcile with claims to ensure proper payment.
Process secondary insurance claims; submit claims to secondary insurance companies.
Process Medicare Part A claims: submit claims electronically to Medicare Intermediary (Novitas); track, edit, adjust and correct claims; files created in NTT and submitted via electronic claims transmission; determine spell of illness to capture Medicare days.
Process Medicare Part B claims (Therapy Billing): submit claims electronically to Medicare Intermediary (Novitas); track, edit, adjust and correct claims; import and export files from Quality Care Rehabilitation Services for contracted therapy services.
Verify appropriate medical coding and apply to UB‑04 Form required by Medicare and private insurance companies.
Create and maintain reimbursement tables for residents; set up plans by changing sequence of payment order; enter resident's insurance info for accurate Face Sheet.
Prepare monthly Medicare Part Census Report: keep track of census for Medicare Part A Billing; determine benefit days available; track remaining days in current benefit period; project benefits exhaustion.
Change resident care level from private to skilled; ensuring correct billing and reimbursement.
Prepare monthly Medicare Part A log (maintain spreadsheet of all charges, payments, coinsurance).
Analyze Remittance Advice from Novitas and EOB from secondary insurance; post payments.
Communicate with Medicare Intermediary (Novitas) and secondary insurance companies to resolve problems.
Communicate with ancillary vendors; establish charges; inform vendors of residents on Medicare Part A.
Provide customer service to residents and families regarding billing inquiries.
Review and analyze denied processed insurance claims and EOBs.
Review, analyze, collect and follow up on self pay for medical services rendered at facility; follow up on co‑payments, deductibles and patient responsibility portions.
Enter health insurance claim adjustment(s) in WellSky (NTT); adjust/reconcile resident's account based on claim payment and EOB.
Complete and submit all applicable forms for CMS – 855A Application, Recertification, CMS – 838 Credit Balance Report, Part A Direct Data Entry DDE Users Due for Recertification, and other CMS Forms as needed.
Process prior authorizations for Medicare Part A and B (as needed).
Assist in managing and distributing ABN letters for facility's residents.
Seniority Level Associate
Employment Type Contract
Job Function Accounting/Auditing and Administrative
Industries: Accounting
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Title:
Medical Coder/Healthcare Billing Specialist
Company: State of NJ
Pay Rate: $29.09 / Hour (W2, no benefits)
Duration: 6+ months
Location: Paramus, NJ 07652
Work Hours: 8 AM – 4:30 PM; Lunch: 30 min Break (unpaid); Work from office or remote: office
Dress Code: Casual Formal
Parking: Yes
Job Description
Equipment : Computer
Computer software : MS Office; Accounting Software
Interview Mode : Personal
Required skills/education : Proficient with MS Office (Word, Excel); Reporting; Creating Memos
Certification : Medicare Part A
Primary duties : Responsible to obtain reimbursement from Medicare and private insurance companies for skilled nursing care; establish cost for medical services; calculate rate for each level of care based on Medicare Fee Schedule.
Process Part A claims in compliance with Medicare guidelines and NJ Administrative Code for Veterans Homes; review, interpret and implement rules, regulations, policies and procedures regarding Medicare billing.
Attend weekly meetings with MDS Coordinator and Rehab Program Manager to review residents' level of care and current billing status (UR Meeting).
Determine SNF days available; project when the patient will exhaust benefits; determine when a resident is entitled to a new benefit period; change resident care level from private to Medicare; update resident's reimbursement to reflect Medicare as primary payer; verify qualifying hospital stay.
Implement appropriate medical coding; apply to UB‑04 form required by Medicare and private insurance companies for proper reimbursement.
Verify accuracy of ICD‑10 Codes prior to claims submission (Triple Check Meeting).
Receive PDPM classification model from nursing department and calculate rates according to Medicare Fee Schedule for each claim.
Provide ancillary vendors with Medicare Part A Census Report; determine accurate charges for ancillary vendors by reconciling invoices and calculating rates according to Medicare Fee Schedule.
Calculate charges and create electronic file for submission to Medicare.
Process Commercial Claims: submit claims to private insurance companies to obtain reimbursement for services provided to residents with Medicare replacement plans.
Utilize Inovalon (Ability Network) to edit, track and adjust claims.
Analyze Medicare remittance advice and reconcile with claims to ensure proper payment.
Process secondary insurance claims; submit claims to secondary insurance companies.
Process Medicare Part A claims: submit claims electronically to Medicare Intermediary (Novitas); track, edit, adjust and correct claims; files created in NTT and submitted via electronic claims transmission; determine spell of illness to capture Medicare days.
Process Medicare Part B claims (Therapy Billing): submit claims electronically to Medicare Intermediary (Novitas); track, edit, adjust and correct claims; import and export files from Quality Care Rehabilitation Services for contracted therapy services.
Verify appropriate medical coding and apply to UB‑04 Form required by Medicare and private insurance companies.
Create and maintain reimbursement tables for residents; set up plans by changing sequence of payment order; enter resident's insurance info for accurate Face Sheet.
Prepare monthly Medicare Part Census Report: keep track of census for Medicare Part A Billing; determine benefit days available; track remaining days in current benefit period; project benefits exhaustion.
Change resident care level from private to skilled; ensuring correct billing and reimbursement.
Prepare monthly Medicare Part A log (maintain spreadsheet of all charges, payments, coinsurance).
Analyze Remittance Advice from Novitas and EOB from secondary insurance; post payments.
Communicate with Medicare Intermediary (Novitas) and secondary insurance companies to resolve problems.
Communicate with ancillary vendors; establish charges; inform vendors of residents on Medicare Part A.
Provide customer service to residents and families regarding billing inquiries.
Review and analyze denied processed insurance claims and EOBs.
Review, analyze, collect and follow up on self pay for medical services rendered at facility; follow up on co‑payments, deductibles and patient responsibility portions.
Enter health insurance claim adjustment(s) in WellSky (NTT); adjust/reconcile resident's account based on claim payment and EOB.
Complete and submit all applicable forms for CMS – 855A Application, Recertification, CMS – 838 Credit Balance Report, Part A Direct Data Entry DDE Users Due for Recertification, and other CMS Forms as needed.
Process prior authorizations for Medicare Part A and B (as needed).
Assist in managing and distributing ABN letters for facility's residents.
Seniority Level Associate
Employment Type Contract
Job Function Accounting/Auditing and Administrative
Industries: Accounting
Referrals increase your chances of interviewing at 22nd Century Technologies Inc. by 2x
Get notified about new Medical Biller jobs in
Paramus, NJ .
#J-18808-Ljbffr