Position Title: Medical Billing Specialist

Schedule: 32 hours per week

Salary: $35.00 - $42.00

Who we are:

Experience the future of senior living and care as soon as you step foot into our doors. Casa de las Campanas offers upscale resort-style living in the scenic area of Rancho Bernardo. Our team of dedicated professionals strives to improve the lives of seniors in our community on a daily basis. Our campus and surroundings reflect the love that our residents have for southern California. Our unique combination of an all-inclusive lifestyle, exceptional hospitality, and stunning location is unmatched. Our well-traveled and outdoorsy senior community enjoys socializing over meals, exploring nearby trails, and taking in breathtaking views. We are currently seeking a talented Medical Billing Specialist for our Health Center. If you want to experience a fresh perspective on senior living, join us today!

You will enjoy:

• Medical, Dental, and Vision Insurance
• Tuition reimbursement program
• An employee appreciation bonus, which is funded by our residents
• Now offering DailyPay!
• Life insurance
• 403 (b) retirement plan with employer match
• PTO and paid holidays
• Pet insurance
• AFLAC
• An exceptional work environment that is both engaging and fun!
• Long-term disability insurance

Who you are:

• High school diploma or equivalent
• Medical Billing Certification
• 1-2 years of Accounts Receivable experience or 3-4 years’ experience in Accounts Receivable, with skilled nursing billing experience

Job Summary:

The Health Center Medical Billing Specialist shall be responsible for all aspects of Health Center Billing, including HMO and Medicare Billing, Accounts Receivable, and A/R Cash Receipts. They shall also provide backup assistance for other accounting staff.

Essential Job Duties

Health Center Billing

• Completes all Health Center billing, including HMO and Medicare is completed.
• Meet daily with the HC Leadership team to review treatment plans and changes in financial status.
• Monitors amended contracts and ensures proper billing rates.
• Verification of Medicare days used.
• Participates in the monthly triple-check process for Medicare Part A & B claims.
• Participate in quarterly compliance meetings and ensure Health Center billings meet all Federal and State guidelines.
• Reconciles the census at month end & notifies appropriate ancillary service providers that bill based on census levels.
• Maintain separate files for Medicare remittances, hospice payments, Medicare denial letters, and monthly training on Noridian for changes.
• Input appropriate billing codes into Vision.
• Ensures accuracy of patient insurance before and throughout admission.

Accounts Receivable & Purchasing

• Ensures all records used for Accounts Receivable are complete and accurate.
• Maintains contract files on Health Center residents.
• Inputs Accounts Receivable information into the computer database.
• Processes Accounts Receivable data and prepares billing statements, including an audit review, for distribution.
• Prepares monthly Accounts Receivable reports and uses them for account analysis and timely follow-up of aging accounts.
• Maintains McKesson software database relating to healthcare supplies. Ensures the charge-capturing system continues to capture data.
• Complete Medicare Credit Balance Report.
• Communicates related accounting data with residents, staff, and others professionally and courteously.
• Follows claims through Medicare audits and appeals to ensure prompt payment and any refunds are issued promptly.
• Verifies that all HMO claims are received promptly via telephone or Internet.
• Assist other departments including purchasing and admissions, MDS, and medical records to ensure a timely billing process
• Bill Medicare co-insurance when appropriate.
• Verify all ancillary charges for accuracy and reasonableness, including oversight of central supplies billing.
Complete the check-off list for Medicare ADR (Additional Documentation Requests) in an organized manner.

Rate of Pay:

$42.00/hr.

All Employees must be able to pass background checks (fitness for duty physical, fingerprinting, employment references) as required by a licensed residential care facility. Some of the roles in our community require that we ask about your COVID-19 vaccination status.

EOE