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Director of Finance - MLTC

RCM Healthcare Services New York Full-Time
$140,000.00 - $150,000.00 / year
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Director of Finance - MLTC Division

Reports to : VP of Finance

Hours:   9:00am – 5:00pm

Salary:   $140 - $150k annually

Supervises data entry of new member's information in Capitation Billing System.

Enters disenrollments in Capitation Billing System.

Processes monthly Medicaid Billing.

Applies weekly Medicaid remittance in Capitation Billing System.

Processes and prepares weekly Denial Report for the Social Services Department.

Supervises process of weekly rebills on denied claims.

Works with Social Work and Clinical Operations to identify and resolve problems.

Prepares "Claims Invoices" for the Entitlement Dept. to give to the State for Denied Claims.

Updates documented changes in member's information in Biiling System.

Processes capitation refunds/credits and maintain Master Refund/Credit Excel Worksheet.

Prepares monthly invoices for doctors for A/P Department for payment.

Maintains monthly AR Aging Report.

Prepares monthly AR Reconciliation.

Processes monthly FIDA billings and enrollment reconciliation.

Processes monthly ISNP billings and enrollment reconciliation.

Prepares monthly "Return of Capitation " reports and chairs the bi-weekly meeting.

Works with Claims Department to verify vendor payments as needed.

Prepares A/P invoices sent to HHAR A/P Department for payment.

Works with Director of Analytical Reporting to respond to various audits (OMIG, OIG, OSC, etc..)

Prepare the monthly Rosters and Revenue Worksheet (MLTC, FIDA and ISNP).

Prepare the monthly AR Reconciliation/Due from/Due to Accounts (MLTC, FIDA and ISNP).

Prepare monthly FIDA and ISNP Direct Care Expense Worksheet forwarded to VP of Finance.

Works with SVP of Finance to certify monthly ISNP roster in HPMS.

Assists VP of Finance with monthly financial closing, including monthly journal entries.

Analyses and prepares Due to Medicaid account monthly.

Analyses and prepares Due from Medicaid account monthly.

Supervises monthly billings, monthly statements, and processing of receipts for surplus.

Maintains monthly Medicare P2P and CGDP worksheets for FIDA & ISNP Plans.

Performs other duties as needed.

 
  • Medicare background required
  • Healthcare experience required
  • Health plan experience preferred

Recommended skills

Claims
Medicaid
Medicare
Billing
Finance
Remittance
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