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CALVIN COMMUNITY is Hiring a Billing Specialst Near Des Moines, IA
Billing Specialist
Calvin Community is nestled in the heart of Des Moines’s Beaverdale neighborhood. Calvin Community is a not-for-profit senior living community focused on serving older adults in a caring, Christian Community designed to meet their physical, social, spiritual, and psychological needs and contribute to their health, security, and happiness. Calvin Community proudly provides high-quality, compassionate services in independent living, assisted living, skilled nursing, long-term care, and memory support care for residents.
The successful candidate for this position must have knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements in a long-term care setting. The candidate must have excellent written and oral communication skills.
Key Accountabilities of the Medicare Billing Specialist include:
Entering insurance and co-insurance and responsible party information into billing system and prepare and transmit claims
Review daily census information
Review, enter and process of private pay statements including ancillary charges, Medicaid, and Medicare claims.
Review of and follow-up of all outstanding statements and claims, including private pay, Medicare, Medicaid and co-insurances.
Assisting with financial information related to long-term care insurance and and/or process long-term care insurance when appropriate.
Responsible for inquiries from the long-term care insurance companies.
Assisting with Medicaid and Elderly Waiver applications as needed.
Review resident statements and correct any missing or inaccurate information
Use of insurance carrier portals for eligibility and claims information; verifying coverage and eligibility for services provided, work with insurance companies to secure any pre-authorizations required for procedures and/or work with counseling staff to secure or track any pre-authorizations for procedures
Collects delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occur.
Entering and balancing of cash receipts.
Requirements and Qualifications:
Experience with long-term care and healthcare billing
Familiarity with CPT, ICD-10, and HCPCS Coding
Exceptional Customer Service skills for interacting with patients regarding medical claims and payments, including communication with patients and family members
Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
Knowledge of medical terminology likely to be encountered on medical claims
Effective communication abilities for phone contacts with insurance payers to resolve issues
Good analytical and problem-solving skills
Job Type:
Full-time
Benefits:
403(b)
Voluntary Benefits (Health, Dental, Vision, and Life)