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Private Duty/Skilled Nursing Billing Clerk Job in Akron, Ohio US

Private Duty/Skilled Nursing Billing Clerk


Posted: 11/20/2019 - Expires: 2/18/2020

Job ID: 213904504

Job Description

About Us

Akron Children's Hospital is one of the largest independent pediatric hospitals in the U.S., and ranked among the best children's hospitals by U.S. News and World Report. Our dedicated staff serves nearly 900,000 patient visits per year through our 2 hospital campuses and a large network of locations offering primary and specialty care.

We are leading the way to healthier futures for children and communities through expert medical care, research, and prevention and wellness programs. As a teaching affiliate of Northeast Ohio Medical University and other universities, we train new generations of pediatricians, specialists, nurses and pharmacists every year.

To treat every child as we would our own
To treat others as they would like to be treated
To turn no child away for any reason

We are seeking people who are committed to fostering a diverse environment in which patients, family and staff from a variety of backgrounds, cultures, and personal experiences are welcomed, included and can thrive.

Shift Information: Day Job

Full Time, Monday-Friday



Private Duty/Skilled Nursing Billing Clerk


Essential Functions and Responsibilities:

Processes and submits paper or electronic claims for services provided by Children's Home Care Group
Maintains a comprehensive knowledge of Medicare, Medicaid, or third-party payor billing requirements as they relate to assigned accounts.
Ensures compliance with insurance billing requirements including timely filing of claims, attaching clinical documentation, physician orders requirements, line item limitations, incremental fee schedules, etc., to avoid denial of reimbursement.
Responsible for comparing payments to account balances to ensure appropriate reimbursement from insurance companies and third party payors. Investigates promptly if payment amount is incorrect.
Responsible to investigate denied claims and resubmit or refer to appropriate department/staff for appeal.
Responsible to maintain assigned accounts receivable within the established standard of number of days outstanding.
Responsible to follow established collection procedures of self-pay accounts and co-pay and deductible balances through the write-off and collections process.
Other duties as assigned.

skilled nursing/private duty billing FUNCTIONS:

Maintains comprehensive working knowledge of payer contracts and ensures that payers are billed according to contract provisions.
Verifies that Private Duty and Skilled Nursing Services are supported by appropriate documentation prior to claims submission.
Verifies that the appropriate modifiers are attached to the charges
Processes denied claims and resubmission as well as payor appeals
Performs Skilled Nursing/Private Duty collections function in compliance with Children's policy.


 High school graduate.
 Minimum of two (2) years prior experience in professional, private duty and/or skilled nursing billing and follow-up experience.
 Must be familiar with UB-04/HCFA 1500 billing and knowledgeable of governmental, managed care and commercial payor regulations.
 Must be proficient in the use of personal computers and Microsoft Office 2003/2007 software and have typing skills at a minimum speed of 35 words per minute.
 Proficient use of copier, fax, scanner, e-mail, and internet website functionality.
 Strong communication, mathematical aptitude, critical thinking skills, and analytical skills are required.
 The ability to communicate verbally and to prepare written communications for patients, patient's families, physicians, third party payors, collection agencies, attorneys and other hospital staff as necessary.
 Ability to use a calculator, type and work on personal computer and other hospital on-line systems.
 Answer phone calls and address, resolve or redirect inquiries.

Akron Children's Hospital is an 

EEO is the law, please click/copy paste the link below to learn more:

Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individual with Disabilities

Job Summary

Employment Type:
Full Time Employee
Job type:
Federal Contractor
Skill Based Partner:
Education Level:
High school graduate
Work Days:
Mon, Tue, Wed, Thu, Fri
Job Reference Code
Licenses / Certifications:
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