Coordinates the orderly processing of all third party claims in accordance with the policies and procedures of the nursing home and regulatory agencies.
JOB RESPONSIBILITIES
Verifies insurance, demographic and financial information supplied for potential residents for accuracy and completeness. Then makes recommendations on admissions and confirms that a viable pay source exists.
Performs timely and accurate cash receipt and Ancillary Services posting to the Accounts Receivable system.Submits claims for third party insurance payers. Handles self pay billing in a timely and accurate manner.
Maintain an accurate and current census within the Keane system.
Promotes/portrays a high level of professionalism, both technically and personally. Possesses strong work ethic and exhibits optimism, adheres to the department dress code policy and maintains a professional appearance and positive attitude.
Promotes positive relationships with support staff, residents and their families, clinicians, and the Department of Social Services. Communicates effectively within the department and keeps management informed on key issues.
Conducts monthly AR meetings to review open balances and aged self pay and Medicaid pending accounts.
Provide technical reimbursement research and assist in reimbursement analysis.
Reviews the reasonableness and consistency of the statistics, investigate fluctuations. Maintains monthly/annual statistical information to be used for financial/cost reporting.
Establishes and maintains private pay collection procedures. Identifies accounts for outside collection activity, interacts with attorneys on high profile accounts as needed.
Recognizes when all charges and payments have been performed which allows the monthly financial close to occur.
Performs other duties as assigned
EXPERIENCE
2 to 5 yrs patient accounting experience
EDUCATION
High School diploma, some college (business administration, or equivalent experience
LICENSES/CERTIFICATIONS
Typing, data entry, mathematical skills, knowledge of computer systems and modern office equipment necessary. Medical terminology, coding medical insurance and familiarity with medical field essential.