Job Summary:

Responsible for billing, coding, DRGs, and insurance payments. Understands Medicare, third party insurance, and Medicaid billing and payments. Must possess knowledge of billing and coding in Point Click Care. Work with patients/families to secure payments, including assisting with Medicaid application.

Responsibilities:

• Registration, billing, collections, and adjustments to accounts
• Billing is accurate and timely
• Responds to inquiries from facilities, residents, responsible parties, government agencies.
• Proper utilization of federal and state credit collection regulations and guidelines
• Rebilling of accounts for late charges, denials, missing codes, and other required information not provided at the time of the initial billing.
• Stays current accounts being rebilled and billing for multi-insurance plans.
• Review of EOBs and ARs to ensure payments are posted correctly.
• Manages Resident fund accounts per state and federal regulations.
• Reconciles the accounts receivable balance every month with the general ledger
• Attends and participates in meetings as required and works with other team members to ensure cooperative working relationships.

Education and Experience:

• Must have a high school diploma
• Minimum of 3 years of experience as a Business office Manager or equivalent thereof
• Knowledge of Medicare, third party insurance, and Medicaid billing

Required Skills/Abilities:

• Excellent analytical and writing skills
• Strong computer skills to include Microsoft Word, Excel, PowerPoint, and database products
• Must be highly motivated and willing to assume additional jobs and duties as needed
• Must be able to handle stress of working efficiently with frequent interruptions and distractions
• Hours must be flexible to accommodate for needs during surveys and unscheduled events
• Must be able to prioritize tasks and adhere to strict deadlines
• Recognizes and responds to priorities, accepts changes and new ideas. Has insight into problems and the ability to develop workable alternatives
• Accepts constructive criticism in a positive manner
• Adheres to attendance and punctuality requirements per hospital policy. Provides proper notification for absences and tardiness. Takes corrective action to prevent recurring absences or tardiness
• Understand, respects and displays sensitivity to culture, age and persons with disabilities
• Participates actively and positively affects the outcomes of customer service activities
• Developing peer relationships that enable the work group to accomplish the daily workload within the allotted time frame and achieve departmental goals
• Timely notification to Department Manager/Director of potential problems or concerns. When faced with a problem or concern, is proactive by presenting suggested solutions at the time that the Department Manager/Director is made aware of the problem or concern
• Displaying teamwork ability to promote cooperation and collaboration; gaining support for programs and goals
• Supports Patient Rights
• Treating internal and external customers as the most important part of the job
• Being sensitive to customer’s emotions, thoughts and feelings
• Refraining from negative comments of any kind where the public or other customers can hear
• Interacts with coworkers, other hospital staff, physicians, and the public in a courteous, professional and efficient manner
• Establishes good rapport and working relationships with coworkers, other hospital staff, physicians and the public
• Observes dress code policy and wears hospital identification as required by our policies and procedures
• Understands and abides by all departmental policies and procedures as well as the Codes of Ethics, HIPAA requirements and patient rights
• Complies with federal, state, local laws that govern business practices. Complies with all Department of Health Services requirements for the State, and CMS standards that apply to the position
• Is knowledgeable and adheres CMS standards specific to the position
• Conducts business in an ethical and trustworthy manner at all times when dealing with patients, visitors, physicians, and fellow employees
• Attends scheduled in-service and mandatory in-service. Communicates ideas to supervisor for a safer layout of equipment, tools, and/or processes.
• Follows standard precautions and transmission based precautions as shown by consistent use of appropriate personal protective equipment
• Complies with all hospital safety and injury prevention policies and regulations
• Understands the Continuous Quality Improvement Process and applies it in performing everyday tasks/duties. Active participant in Continuous Quality Improvement program by assisting in finding new and better ways of performing duties and responsibilities

Physical Requirements:

• Sitting 3-6 hours a day
• Wrist deviation (side-to-side and up and down) 3-6 hours a day
• Occasionally lift up to 50 pounds
• Occasionally have the potential to be exposed to hazardous chemicals or infections