What are the responsibilities and job description for the Managed Care Billing Specialist - Cantex Continuing Care Network position at Cantex Continuing Care Network?
Job Details
Description
Diversity, Equity, and Inclusion are at the heart of Cantex. We are committed to a culture that respects our differences and values the contributions of all people.
Job Summary:
The Managed Care/Advantage Billing Specialist has the responsibility for managing the accounts receivable, billing and collection related functions for multiple Skilled Nursing facilities in the state of Texas. Focus will be on the managed care/Medicare revenue cycle in order to optimize revenue, improve cash flow and strengthen the company’s financial position. This position will be responsible for managed care and Medicare claims.
Qualifications
Qualifications:
- Preferred Managed Care Billing experience in Skilled Nursing/Long-Term Care
- Understanding Insurance Contracts
- Preparing claims for Managed Care/Insurance Billing
- Reviewing claims until processed for payment
- Utilizing Insurance sites for eligibility, benefits, claim status, appeals, reconsiderations, etc.
- Provided documentation as requested for Insurance claims
- Perform other assigned duties
Essential Functions:
- Processes monthly billing for managed care claims and Medicare Part A services.
- Claims creation and working denials.
- ICD 10 understanding.
- Verifying Medicare eligibility and coverage days available.
- Payment posting.
- Answering provider questions.
- Ensure billing is accurate, complete and in compliance with State and Federal regulations.
- Coordinate third party billing with nursing facility personnel as necessary.
- Communicates and works in cooperation with fiscal intermediaries, accountants, auditors, cost report preparers, state and federal agencies and private insurance companies.
- Monitors facility receivable balances and maintains receivable balances within acceptable limits, as well as assists with collection of problem accounts.
- Understand billing software capabilities and lead efforts to enhance efficiencies.
- Understand software and regulatory requirements for transmitting claims to the various third party payers.
- Analyze and resolve technical questions regarding billing including transmission to payers, calculating claims, printing bills, resident accounts, etc.
- Ensure all required billing compliance and regulatory initiative are met.
- Compiles and prepares data and reports as required.
- Strives to meet company DSO and collection goals every month.
- Ensures compliance with Cantex policies and procedures including Financial Management Systems.
- Performs other duties and tasks as assigned by the AR Manager, Director of Finance or CFO.
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We are an Equal opportunity employer; We offer an excellent benefits plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.
