Medicare Biller

The CommuniCare Family of Companies currently owns/manages over 100 World-Class Nursing and Rehabilitation Centers, Specialty Care Centers, and Assisted Living Communities throughout Ohio, Missouri, Pennsylvania, Indiana, West Virginia, Virginia, and Maryland. Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and management of adult living communities.

CommuniCare Health Services is currently recruiting a Medicare Biller for our Central Billing Office in West Virginia. We are accepting candidates from all over, not limited to West Virginia!

PURPOSE/BELIEF STATEMENT

The position of Medicare Biller is responsible for billing, receivables auditing, and collections activities for services provided to patients in the facilities assigned. Ultimately they are responsible for hitting their cash collection goals each month and minimizing the impact of Bad Debt for the buildings/facilities assigned to them.

WHAT WE OFFER

As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer you a menu of benefit options from life and disability plans to medical, dental and vision coverage, from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts. Qualified candidates, forward your resume for a chance to join the World Class team at CommuniCare!

QUALIFICATIONS / EXPERIENCE REQUIREMENTS

• Knowledge of Medicare & Secondary Billing Guidelines
• Previous experience billing various Medicare and Co-insurance companies and understanding the requirements for each payor
• Claims appeal/resolution expertise preferred
• 2 - 4 years advanced education beyond high school, or comparable work experience
• Strong verbal and written skills are required in order to interact with insurance companies to resolve unpaid claims via telephone and written correspondence
• Professional appearance and mannerisms
• Ability to work as part of a team
• Computer skills including, but not limited to Microsoft Word, Excel, and Outlook
• Knowledge of Medicare DDE, e-Solutions, Point Click Care and Quadax preferred

JOB DUTIES & RESPONSIBILITIES

• Verify receipt of monthly triple check forms and audit for accuracy per triple check policy prior to claims submission
• Review of Medicare A, Medicare A No Pays/Benefit Exhaust, Medicare B, and Medicare Secondary Payer claims for accuracy and timely submission per Medicare, Commercial, and Medicaid billing guidelines
• Submission of Medicare Advantage Copy claims
• As Medicare payment occurs, identify and submit billing for secondary claims that do not automatically crossover to secondary insurance
• Daily cash posting of Medicare and Secondary payments per Cash Postings policy
• Follow-up on unpaid claims and document account within standard billing cycle time frame (Medicare: 16 days after submission , Commercial/Medicaid Coinsurance: 14-21 days after submission)
• Monitor for and report Medicare additional development requests (ADR’s) per process guidelines
• Identify and submit necessary rebilling for secondary / tertiary claims during follow-up
• Conduct account research and analysis
• Submission of write offs for uncollectable accounts
• Identify and create batches for necessary billing adjustments
• Creation and submission of cost Report Bad Debt write offs for states assigned to Medicare CBO, per Medicaid billing guidelines
• Accurately prepare and maintain various reports to include: Monthly Cash Report & Shortage Explanation, Triple Check Audit, Credit Balance Report
• Interact with facility staff to resolve outstanding issues
• Participate in monthly A/R reviews
• Participate in the month end close process.
• Other various duties as assigned

About Us

A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients, and family members care for and about one another.