Job Summary

Responsible for managing accurate, timely completion and submission of all billing, collections, and accounts receivable functions for the agency.

DUTIES & RESPONSIBILITIES

• Ensures reimbursement through efficient billing and collections operations and effective accounts receivable management.
• Provides oversight and approval of claims audits and processing. Conducts final billing audit and issues assignments to pre-billing team when findings require further documentation.
• Ensures that billing and patient accounts record systems are maintained in accordance with generally accepted accounting principles and in compliance with state, federal and Joint Commission regulations.
• Maintains comprehensive working knowledge of payer contracts and ensures that payers are billed according to contract provisions.

Represents and acts on behalf of agency in resolving conflicts with payers.

• Advises Executive Director in matters of accepting / declining problematic payers.
• Maintains comprehensive working knowledge of government billing regulations including Medicare and Medicaid regulations and serves as a resource for appropriate agency personnel.
• Monitors aged accounts receivables and resubmit bills to overdue accounts, submits seriously overdue accounts to collection agencies for collection, and prepares bad debt reports for weekly meetings.
• Gathers, collates, and reports key billing information to billing team. Works with Executive Leadership Team in strategizing monthly, quarterly and annual goals for optimized billing efficiency.
• Collaborates with the Executive Director in successfully reconciling the billing system reports with the general ledger.
• Reconciles Medicare quarterly reports produced by the fiscal intermediary with the billing information system, and prepares the annual Medicare cost report for Executive Director review.
• Supervises the use of the billing information system and maintains a comprehensive working knowledge of the system including upgrades and enhancements.
• Supervises and reconciles cash receipts and bank deposits according to policy.
• Establishes and maintains positive working relationships with patients, family members, payers and referral sources.
• Protects the confidentiality of patient and agency information through effective controls and direct supervision of billing operations.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job.

The incumbents may be requested to perform job-related tasks other than those stated in this description.

• Associate degree in accounting, Business Administration or related field, Bachelor’s degree preferred.
• At least three years’ experience in health care billing and collections management preferably in home care operations.

Billing information systems knowledge required.

• Knowledge of corporate business management, governmental regulations and Joint Commission standards.
• Ability to exercise discretion and independent judgment and demonstrate good communication, negotiation, and public relations skills.
• Demonstrated capability to accurately manage detailed information.
• Able to deal tactfully with patients, family members, referral sources and payers.
• Demonstrates autonomy, assertiveness, flexibility and cooperation in performing job responsibilities.

We understand many elderly patients face daily struggles with physical or emotional changes that come with illness and / or age.

Far to often, these types of struggles are hard to discuss with family members as keeping ones independence is very important.

With the right planning and team in place, here at Emblem we believe we can keep our patients happy, comfortable and provide a quality of life that is enjoyable all from the comfort of their own homes.

To accomplish this goal, our Service Officers follow a very detailed intake process.

Last updated : 2024-04-27