Job Requisition : REQ2853

Employment Type : Full-Time

Shift : Days (8am-4 : 30pm)

Hours Per Week : 40 hours

The actual compensation for this position will be determined based on experience and other factors permitted by law.

Responsibilities :

• Verifies resident insurance benefits and financial information. Maintains resident files and information to support charges.
• Maintains and reviews daily resident census and payer information to ensure accuracy. Includes the Adult Day Care census, daily charges, cash entry, and obtaining and renewing authorizations and roster spreadsheets.
• Handles Medicaid application information and recertification for residents.
• Works with County Case Manager to maintain Medicaid eligibility.
• Inputs ancillary charges from various vendors, including import of monthly therapy charges file.
• Creates and distributes monthly private pay statements.
• Completes month end close and all associated financial and statistical reporting.
• Coordinates monthly triple check meeting with MDS Coordinator and other staff.
• Responsible for filing insurance claims to appropriate primary and secondary payers, meeting all government and third-party regulations.
• Responsible for posting of cash receipts, including distribution of electronic remits and processing refunds and adjustments.
• Monitors outstanding accounts receivables and follows-up on collection problems, including insurance denial and appeals, collection calls and letters.
• Works collaboratively with external collections firm to place, track progress and close past due accounts.
• Manages resident banking, the deposits and withdrawals, monthly interest distribution and quarterly statements in compliance with state regulations.
• Keeps current with regulatory requirements and maintains billing software setups and parameters, accordingly, including annual rate table changes.
• Works with Electronic EMR (Matrixcare) setting up any new regulations regarding billing and electronic submissions.
• Assists management and administrator with quality assurance audits, budgeting, cost reporting, annual audits, and special projects, as requested.

Qualifications / Skills :

• Excellent customer service and problem-solving skills
• Proficient with Excel (spreadsheet) and word processing programs
• Working knowledge of NYS skilled nursing billing and ability to learn and master various software programs (Matrixcare EHR preferred, but not required)
• Knowledge of governmental regulations (Federal and State)
• ICD-10 Coding experience preferred.

Education :

High school diploma or GED required. Associate's or Bachelor's degree preferred. Must be able to speak, read, write and follow instructions in English.

Personal Protective Equipment :

• Follows Standard Precautions using personal protective equipment as required.

Last updated : 2024-06-20