Job Description
• Submit claims accurately and timely, according to each payor type for which responsible • Confirm that each billing has been received. Confirmation method varies with payor type, but may include confirming on-line or calling • Assist in maintaining daily census, make bank deposits, determine and verify patient status period, patient file maintenance and statements • Determine and verify patient payment status, Medicaid certs, CWF • Maintain computer TAR file, monthly reauthorization TARs to facility; maintain unbilled list; record receipt of Medicaid certs. Monitor for receipt of timely approvals • Process Notice of Action DHS 6114 and bill. • Submit Medicaid claims to appropriate office, handle claims inquiries. 2 • Process all ancillary invoices including verification of timely payments • Run and review monthly analysis reports, as required • Keys information into computer systems, including EMR • Audit therapy logs and invoice • Billing of other charges, as applicable • Process refunds promptly • Monitor and/or complete Medicaid application process for initial and manual redeterminations • Process all pay types of billing • Oversee collections on all accounts receivable • Handle completion of required procedures for end of month closing • Handle accounting functions of the resident trust account JOB FUNCTIONS: • Demonstrate knowledge of, and respect for, the rights, dignity and individuality of each resident in all interactions • Appreciates the importance of maintaining confidentiality of resident and facility information • Demonstrate honesty and integrity at all times in billing and in care and use of resident and facility property • Strict adherence to the Corporate Compliance Program and Standard of Conduct • Must be able to key information into computer systems • Able to understand and to follow written and/or verbal directions. Able to express self adequately in oral and/or written communication. Able to communicate effectively with staff members, vendors and agencies. Demonstrates ability to prioritize tasks/responsibilities and complete duties/projects within allotted time • Ability to follow through and complete tasks with minimum supervision • Encourage teamwork through cooperative interactions with co-workers and departments. Support a positive and professional image through actions and attire • Able to respond to change productively and to handle additional tasks/projects as assigned • Able to carryout the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of self and others • Other duties as assigned
Education: High School graduate or equivalent Work Experience: Background in billing in a Skilled Nursing Facility (SNF), knowledge of Medicare/Medicaid, HMO billing processes. Accurate keyboarding, calculating and computer ability is necessary. Language Skills: • Must be able to read, analyze, and interpret common scientific and technical information, and to be easily understood through verbal communication in the English language. Mathematical Skills: • Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. • Ability to perform these operations using units of weight measurement, and volume. Communication Skills: • Must have exceptional communication and customer service skills, and be empathetic. • Ability to effectively communicate with patients, families, responsible parties, staff and outside resources and agencies.