- Houston, TX, US
- REQ #:
- Posted at:
- 2020-01-22 20:00:07
Responsible for providing timely and accurate billing and collections support to all billing analysts in the event of absences, openings, or performance issues. Performs monthly review of accounts receivable aging for all resident account balances and acts to meet expectations of ADSO and percentage of aged Accounts Receivable to total Accounts Receivable. Responsible for resolving escalated business issues. Adjust workload timing and request training to meet business needs of the facilities served. Responsible to coordinate all Managed Care and Insurance Exclusion (or Carve Out) Billing. Responsible to coordinate with IT on setup of Managed Care and/or Insurance Plan.
Essential Duties & Responsibilities
- Billing/Claims Processing:
- Manages the billing of claims to ensure timely and accuracy of billing for assigned payer(s).
- Analyzes claims and determines appropriate adjustments.
- Produces and presents progress against performance measures.
- Adheres to and gives feedback to Management related to billing policies and procedures.
- Completes all expectations within specified deadlines.
- Analyzes and reviews charts to ensure acceptable documentation supports billing of services.
- Ensures quality assurance of claims related to contracts and agreements from Third Party Vendors.
- Manages billing of all Managed Care and Insurance Exclusions (or Carve Outs)
- Provides temporary support to billing analysts in the event of absences, openings, or performance issues
- Responsible to Coordinate with IT Department on setup of Managed Care and Insurance Contracts
- Account Management:
- Accountable for timely collections of outstanding accounts.
- Reviews and corrects claims for internal system-identified errors
- Conducts analysis of all accounts to complete timely adjustments to AR/claims, including write offs and refunds. Analyze revenue impact to the Income Statement from adjustments.
- Prepares state and/or government audit reports as required including quarterly credit balance for Medicare.
- Facility Support:
- Ensures accurate and timely status of assigned accounts during monthly AR reviews.
- Communicates with the facility staff to gather necessary supplemental information.
- Communicates with supervisor regarding trends and suggested solutions.
- Ensures appropriate adjustments for each account by researching and identifying account payment differences. Includes contract/agreement review, revenue analysis, account management, and P&L adjustments. In the case of write offs or refund processing, conducts appropriate research to ensure appropriate decision is made before processing.
- Identifies claims/account issues. Submits trend analysis to manager with recommended process changes to correct going-forward issues (e.g. reporting change, facility process improvement, etc.).
- Completes various administrative activities & performs other duties as assigned.
- Associate's Degree or equivalent experience required, Bachelor's Degree preferred.
- Minimum 2 years of applicable experience in a healthcare (long-term care preferred) billing and collections environment.
- Understanding of healthcare business service functions, including billing and collections, including UB04, in a Long Term Care environment preferred.
- Elevated level of customer service experience.
- Must be proficient in the use of a personal computer and windows environment software with intermediate level of keyboarding skills.
- Intermediate level of MS Office Products - Word and Excel.
- Must have strong interpersonal skills including verbal and written communications.