REPORTS TO: Administrator

RESPONSIBILITIES: Direct the overall Business Office activities in accordance with current applicable federal, state, and local standard guidelines and regulations and as directed by the Administrator to assure the proper administrative procedures are maintained.

QUALIFICATIONS:

• Associates degree in accounting or related field or two years of experience.
• Previous experience in long term care business office operations preferred.
• Ability to speak clearly and hear well enough to communicate with others.
• Ability to understand, remember and carry out oral and written instructions in English
• Must be capable of performing the Essential Job Functions of this job with or without reasonable accommodations.
• Experience with PointClickCare and/or NetHealth preferred

ESSENTIAL FUNCTIONS:

• Completes Daily Census Worksheet and tracks census for accuracy. Reconcile census worksheet and accounts receivable system census reports. Reconcile to 24 hour nursing report. Adjust accounts receivable and statistical reports as necessary to maintain accurate census records.
• Distribute reconciled Daily Census Worksheet to required distribution listing each morning by 10am.
• Reconcile monthly census worksheet with accounts receivable monthly census reports and sends to regional office.
• Obtains face sheet and Admission Packet from admissions and verifies accuracy and completeness Inputs patient master information into the accounts receivable system and updates as necessary by 10am each morning for accurate census reporting.
• Verify benefits on all new admissions and monthly thereafter.
• Meet every new Admission Responsible Party and complete Financial Acknowledgement Form for each admission and secure accurate financial information.
• Collect all payments due upon Admission and by the 5th of every month thereafter.
• Complete Monthly Medicaid Occupancy Report.
• Submit mandated 3618 and 3619 admission and discharge notices to the Dept. of Health and Human Services accordingly.

• Monitor SimpleLTC for Invalid/Provider Action forms and follow up with Nursing Home Billing.
• Gathers resident monthly ancillary charges; inputs ancillary charges and adjustments into the computer system. Review monthly ancillary charge list for accurate AR Type allocation.
• Consults with Regional Account Manager to resolve errors in accounts.
• Prepares billing forms, reports and/or attachments for third party payer sources.
• Generates and reviews private pay invoices and distributes to responsible party.
• Assures that bills are paid in a timely and accurate manner. Notifies Administrator of any patient accounts older than 30 days; Follows up on collection of bills.
• Notify Administrator of any Involuntary 30 Day Discharge letters needed and coordinate with Legal Department.
• Weekly AR Reviews with Administrator and email to Regional Account Manager as part of Weekly Reports due every Thursday.
• Participate in Monthly AR Reviews with Regional Account Manager.
• Reviews aged receivable reports; Researches past due accounts; Maintains individual collection records on past due patients in an AR Collections Binder
• Deposit cash receipts via check scanner and post payments in the accounts receivable system and ensure timely deposits.
• Reviews credit balances and request patient refunds. Prepares patient refund records request and send to the CBO Refunds Team with following the procedure and process on a weekly basis.
• Answers telephone inquiries and routine correspondences concerning amount of patient account balances.
• Participate in monthly Medicare & Insurance Triple Check, prepares and reviews monthly Medicare Part A, Medicare Part B, Insurance Part A and HMO Part B claims and notify CBO when ready for submission to for billing.
• Act as billing liaison between CBO Office and residents/families.
• Resolve all billing rejections and denials in Zirmed Workgroups assigned the Facility level.
• Work with each family member/resident to ensure timely and accurate initial certification and recertification for Medicaid benefits.
• Submit Status Request on Medicaid Pending applications and work closely with HHSC to ensure completion of Medicaid Applications.
• Weekly Medicaid Pending Reviews with Administrator and email Medicaid Pending Logs to Regional Account Manager as part of Weekly Report due every Thursday.
• Review MESAVs weekly for accurate payer data, Applied Income, and ensure Medicaid benefits are billable for the CBO Office.
• Update facility Medicaid Tickler on a monthly basis for any upcoming Medicare certifications
• Immediately communicate correspondences from fiscal intermediaries and other to the CBO Office.
• Submit Medicare Bad Debt and General Bad Debt write offs to Regional Account Managers for additional approvals.
• Monitor Bad Debt level and avoid a significant increase
• Work with Cash Applications Team and have cash reconciled on a daily basis and by the 1st Business Day of every month for Month End Close.