Job Classification: Full-Time Regular

Purpose:

POSITION SUMMARY:


Responsible for coordinating the billing and collection of Medicare Part A & Part B coinsurance balances to Insurance Carriers for all owned facilities.
  
REPORTING RELATIONSHIPS: 


 


ESSENTIAL FUNCTIONS:


1.         Review Medicare Payments and identify claims that automatically cross over to the secondary payer.  Prepare and submit claims for the claims that have not crossed over.
 2.        Identify and monitor crossover claims in which a �disconnect� exists.
3.         Daily follow up on account activity to include account
4.         Code payments for data entry and deposit.
5.         Daily follow up with insurance companies to research claims that have not been paid and determine the appropriate action.
6.         Review and process all account adjustments and commercial insurance refunds that have been submitted by the facility.
7.         Respond to facilities and payer�s inquiries regarding claim billing issues.
8.         Report claim status to the appropriate levels of management and track claim payment and billing trends.
 
Other Duties:


Other duties as assigned.
 
 
 
 
MINIMUM QUALIFICATIONS:


Education: High school diploma or equivalent preferred.

 
Experience: Minimum of one year spent in a health care setting, preferable in a long-term care environment, processing Medicare or Insurance claims via electronic or manual submission.  Experience with health insurance claims preferred.

 
Skills, Knowledge and Abilities: Proficiency with Micosoft Excel and Word.  Ability to effectively communicate with all levels of staff both orally and written.  Ability to read, write and understand simplex and complex sentences.  Ability to take and transfer, and interpret information.  Ability to interact with others to accomplish work.