Medicare/Medicaid Billing Representative

Must have Long Term Care Billing experience and Medicaid/Medicare, commercial insurance, managed care, coinsurance and private pay and collection experience!

Job Summary The primary purpose of the Business Services Representative position is to prepare routine billing for Medicare/Medicaid, commercially and managed care insured, and private pay residents, in addition to monitoring and pursuing collection of outstanding accounts from residents and/or sponsors and third-party payors. Also has responsibility for processing related resident admissions, stay, and discharge records.

Job Functions Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties to be performed. The omission of specific duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.

Duties and Responsibilities:

• Review, monitor and actively request accurate completion of documentation necessary for billing from the admissions and nursing disciplines and from outside organizations or agencies including the local Department of Social Services, local Health Department, utilization review sources, etc.
• Compute, collate and issue bills and related documents on a monthly basis to private pay residents and third-party payors.
• Answer family/resident inquiries regarding insurance coverage and account balances.
• Monitor the aging of accounts receivables and payor status on an ongoing basis and initiate contact with residents, sponsors, or third-party payors to collect on outstanding accounts.
• Maintain accurate resident files/information required for billing purposes.
• Log collection follow-up efforts and results, keeping controller apprised of delinquency issues as appropriate.
• Process and post daily charge slips and cash receipts to resident accounts, maintaining receipts per the COMAR.
• Record payments received to appropriate cash receipts journal.
• Prepare and file billing records and documents.
• Work with eligible residents and their families to apply for applicable state assistance programs.

Working Condition

• Operates in a professional office environment, routinely using standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines.
• Interacts with various functional areas throughout the facility, moving intermittently during working hours.
• Is involved with residents, family members, personnel, visitors, government agencies/personnel, etc., under a variety of conditions/circumstances, some of which might be emotional or hostile.
• May be subject to frequent interruptions.
• Is subject to exposure to infectious waste, diseases, conditions, etc., including TB, COVID, Influenza, Hepatitis B viruses and other communicable viruses.

Educational Requirements

• High school diploma.
• Higher education in accounting or healthcare-related fields is desired.

Experience/Requirements

• Proficient computer skills in word processing, spreadsheets, and databases.
• Ability to deal effectively and tactfully with a wide variety of individuals in person, via telephone, and in writing.
• ·bility to work independently and resolve practical problems.
• Excellent organizational skills and ability to work well under stress, despite numerous interruptions.
• Accuracy and attention to detail.
• Working knowledge of Medical Assistance or third-party insurance and Medicaid/Medicare billing is desired.

Physical and Sensory Requirements

• Must be able to move intermittently throughout the workday.
• Must be able to speak and write the English language in an understandable manner.
• Must be able to cope with the mental, emotional, and physical stress of the position.

Job Type: Full-time

Pay: From $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Application Question(s):

• Proficiency in Microsoft Office programs is required

Experience:

• Medical billing: 1 year (Required)
• Nursing home experience: 1 year (Preferred)
• Organizational skills: 1 year (Required)

Work Location: In person

Salary : $25