Essential Job Functions:

1. Responsible for accounts receivable collections to include data entry into PCC collection module, along with supporting documentation;
2. Manage accounts receivable for all payor sources, for the community; responsible for insurance denial process and ADR requests;
3. Conduct periodic accounts receivable reviews with both the Assistant Executive Director and the corporate Finance department; help mitigate write offs
4. Manage financial discharge process to include meeting with all responsible parties to ensure collection of any outstanding account receivable balances. Must verify forwarding addresses and responsible party's contact information. With approval from corporate Finance department, may set up a payment plan;
5. Serve as the contact person for any billing or insurance questions;
6. Manage the Medicaid eligibility and application process and provide periodic updates to the Assistant Executive Director and corporate Finance department;
7. Managing Medicaid billing and supporting functions; responsible for the accurate submission of Medicaid billing, and research of denied claims for necessary follow-ups.
8. Attends all required meetings to support billing functions for residents;
9. Participate in regular review of PCC trial billing and then communicates changes and approval to corporate Billing Specialist;
10. Attend monthly billing Triple Check meetings;
11. Communicate and assist in billing and marketing adjustments. Approval required by both Executive Director and corporate Finance department;
12. Manage process for mandatory payment methods, such as ACH or trust fund;
13. Manage Medicaid and private Trust funds to include: monthly bank reconciliations; reconciliations to PCC; application of State of Texas rules and regulations; and audits;
14. Maintains accurate and updated records of all billing and collections processed at the community;
15. Meets regularly with residents' responsible party to discuss financial responsibilities, resident billing statements, retrieve additional information and collect payments;
16. Assists residents and families with setting up LTC insurance policies;
17. Able to assist with insurance benefits on all new admissions to assure admission meets financial criteria;
18. Supports and assists in the admission process with all responsible parties;
19. Manage daily PCC data entry for census: admissions, discharges, transfers, payor changes and Medicaid applied income. This also includes obtaining prior authorizations for managed care services after initial admission including concurrent reviews;
20. Support the therapy department to ensure correct census; correct payer source; prior authorization/verification and billing accuracy; physician orders are obtained timely throughout process of each patient/resident; Manage issuance of all Medicare Part A, B and managed care in required notices; concurrent reviews;
21. Participates in weekend admissions on-call rotation; and
22. Other duties as assigned.

Additional Responsibilities:

1. All job responsibilities are to be performed and are subject to change as deemed necessary by management.
2. Employee is required to comply with attendance and tardiness standards established by management.
3. The functions of this job position are subject to possible modification to reasonably accommodate individuals with disabilities to permit them to perform essential job functions.
4. Employee is required to comply with all safety procedures and to follow universal precautions and infection control policies and procedures.
5. Employee is required to use proper body mechanics.
6. Some requirements of the job position may exclude individuals who pose a direct threat to the health or safety of themselves, other employees, residents or the public.
7. Employee is required to comply with other job-related instructions and to perform other job-related duties requested by their supervisor.
8. Employee may be assigned to work in any Administration area.
9. Employee is required to understand OSHA's Safety Data Sheets (SDS), where this information is located and what action needs to be taken when an accident occurs with chemicals.
10. Employee is required to know the community's exposure control plan, where this information is located and what action needs to be taken when an accident occurs with blood or other infectious materials.

Qualifications:

1. Education: High School Diploma or GED, some college preferred.
2. Training and Experience: 1 to 2 years business office experience. Detailed oriented and excellent organizational, communication and follow-through skills.
3. Certifications and Licenses: None
4. Job Knowledge: Ability to understand billing and collections, to include Medicare, Medicaid and managed care, and explain these payor sources to residents and/or families. Must have an understanding of medical terminology. Able to use computer, phone, copier, fax and postage machines. Proficient in Microsoft Office software to include Word and Excel programs. Ability to communicate effectively in written format and oral presentations.

Morningside Ministries Immunization Policy: All employees will be required to receive or show proof of receipt of an approved COVID-19 vaccine as a condition of employment, except where a legally authorized religious or medical (not personal preference) or otherwise legally protected exemption is established. Reasonable accommodations such as Personal Protective Equipment (PPE) like face masks, face shields and other protective equipment or safety measures may be identified as reasonable accommodations enabling the performance of essential job functions.
Core Anchors - Good to GREAT Customer Service: To perform this job successfully, an individual should strive to provide Good to GREAT customer service and demonstrate our Core Anchors of People First...Always; Compassionate Action...Now; and Respectful Communication...Everywhere. GREAT is an acronym for the following principles: G reet with a Smile and by Name; R espect the Whole Person; E mpathize; A ccept Responsibility; and T eam up for Success.
Working Conditions: Works in a clean, well-lighted, ventilated building. Occasional travel is required between community locations to include but not limited to travel to conferences, events, and meetings.
Physical Demands: Standing, sitting, walking, lifting-up to 30 lbs., handling, fingering, pushing, pulling, carrying, reaching, overhead, reaching forward, reaching low, stooping, kneeling, climbing, crouching, twisting motion, and balancing. Corrected vision to 20/20 and hearing to normal range.
Special Demands: Must have discretion in judgment, tact and courtesy in dealing with residents, employees and general public.