Job Description

Position Scope:

Accounts receivable support for SNF and ALP billing and collections of Medicaid and Managed Medicaid

Qualifications/Education/Experience:
High School Diploma or equivalent

Knowledge of Medicaid guidelines and billing requirements

Ability to work closely with DSS Medicaid Office County employees

Microsoft Office, Excel,

Customer Service Experience

Computer, mathematical and statistical competency

Responsibilities:

• Manages necessary census changes as pertain to billing for SNF’s
• Managed LTC Authorizations as they pertain to SNF Managed Medicaid billing and maintain PCC with necessary information
• Accurately completes the weekly billing of SNF’s billing for Medicaid, Managed Medicaid, ALP Medicaid, and Medicaid transport.
• Obtain transport authorizations with MAS to ensure timely billing and collections of transport
• Recommend unauthorized transport trips for write off
• Ongoing follow-up of Medicaid SNF billing denials/errors and follow up with counties to assist in solution
• Data entry
• Review AR Aging to ensure Medicaid co-insurance billed and paid timely
• Bill all retroactive Medicaid Budget claims timely and in sequence to ensure timely and accurate
• Handle all denials for billed unpaid claims and follow up
• Extensive follow up of EOBs and AR Aging mandatory and required with favorable outcome to the facility
• Ensure that claims are not denied for timely filing or authorization rejection reasons
• AR Aging review and working of open balances
• Other duties as assigned

HIPAA Compliance:

Demonstrates knowledge of and adheres to CWP policies and HIPAA regulations governing the confidentiality and security of protected health information for both manual and electronic resident records, charts, information and other confidential information including (but not limited to) employee records, computer access codes and passwords.

Physical and Sensory Requirements: (With or without the aid of mechanical devices)

• Appropriate professional attire as required by CWP dress code.
• Must possess the ability to make independent decisions when circumstances warrant such action.
• Must possess the ability to deal tactfully with staff, residents, family members, visitors, government agencies, and the general public.
• Must possess leadership and willingness to work harmoniously with and supervise professional and

non-professional staff.

• Must have patience, tact, cheerful disposition and enthusiasm, as well as be willing to relate to residents

based on the level at which they are currently functioning.

• Must possess the ability to seek out new methods and principles and be willing to incorporate them into

existing practices.

• Must be able to speak and write the English language in an understandable manner.
• Must possess sight/hearing senses or use prosthetics that will enable the senses to function adequately so that the requirements of this position can be fully met.
• Must function independently and have flexibility, personal integrity, and the ability to work effectively with residents, staff and support agencies.
• Must be able to relate to and work with ill, disabled, elderly, emotionally upset and at times, angry people within the facility.
• Must be able to lift, push, pull, and move a minimum of fifty (50) pounds.
• Must be able to assist in the evacuation of residents.

Company Description

Community Wellness Partners (CWP) offers the most complete continuity of health and wellness services for older adults in Oneida County. These services are provided by three wonderful local campuses, of which CWP is the parent organization of LutheranCare®, Presbyterian Homes & Services, and Preswick Glen. CWP is also a 501(c)(3) nonprofit with the mission of caring for older adults by providing them the best services possible.

Benefits

• Health Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance
• 403(b) Retirement
• Tuition Reimbursement
• Paid Holidays
• Paid Vacation
• Monthly Employee Retention Events