At Mount St. Rita (A Covenant Health Affiliate), we’re committed to being a skilled, knowledgeable, and reassuring presence for every person who comes to us for care. Providing patient-focused care is a genuine calling and a sacred trust for us. If you have a heart for bringing your best to each individual interaction you have, we invite you to join us.

***The rate of pay displayed reflects the beginning of the pay scale. At the time of an offer, determination of your offer will reflect your skills and experience as it relates to the position.***

Job Description

Job Title: Billing Specialist

Department: Finance

Reports To: Accounts Receivable Manager

FLSA Status: Hourly/Non-Exempt

Approved By: Regional Controller/Accts Receivable Manager

Approved Date: January, 2023

Summary:

Verify and accurately post accounts receivable transactions to journals, ledgers and other records. Maintain resident personal needs accounts including making deposits and withdrawals, paying resident bills, balancing account weekly. Submit bills to residents, families and insurance carriers. Interface with state and federal agencies, commercial insurance carriers, family members and residents to resolve account balances. Work with residents and families to complete annual accounting requirements for Social Security and Medicaid. Prepare and enter deposits for nursing home and assisted living. Provide insurance verification information to both internal staff and vendors as needed.

DEPARTMENTAL EXPECTATIONS OF EMPLOYEE:

Adheres to MSR's Policies and Procedures

Acts as a role model within and outside of the organization

Performs duties as workload necessitates

Maintains a positive and respectful attitude

Demonstrates flexible and efficient time management and ability to prioritize workload

Consistently reports to work on time and prepared to perform duties of position

Meets department productivity standards

Maintains work operations by following policies and procedures; reporting compliance issues.

Maintains quality results by following standards.

Protects Nursing Facilities value by ensuring highest level of confidentiality.

Adheres to department dress code

Assist other department personnel when needed

Essential Duties and Responsibilities include the following. Other duties may be assigned.

Nursing Home Account Receivable Tasks May Include:

• Verify insurance coverage for potential admissions.
• Collect, enter and report on Nursing Home census on a daily basis.
• Review census information for Assisted Living facility to ensure accuracy
• Bill Medicaid and Medicare on a monthly basis and follow up on all denials and re-billing using a variety of software programs.
• Bill and follow-up for collection of all co-insurance, commercial insurers and Assisted Living billing.
• Collect on unpaid claims, make payment arrangements, monitor and pursue delinquent accounts for self-pay and patient paid accounts.
• Preparation of adjustment requests as needed to correct billing information.
• Review incoming mail to ensure financial information for residents is correct. Make calls on residents behalf to doctors, hospitals, etc. to give updated insurance information.
• Assist families and residents with Social Security discrepancies.
• Update all Medicaid resident pertinent resources information as necessary.
• Research and resolution of credit balances including rebilling, refunding and adjusting.
• Update Medicaid bill rates based on updated MMQ scores provided by MMQ Coordinator.
• Review all patient paid amounts (PPA) for accuracy, adjust as needed.
• Patient Needs Account Duties (PNA)
• Maintains banking hours for Resident Banking function.
• Maintains Resident Patient Needs Accounts (PNA) as required by Medicaid regulations.
• Disburses cash and writes vouchers and checks in payment of resident approved expenditures.
• Posts date and balances to PNA accounts.
• Adjust PNA for billing
• Prepares PNA account report and distributes to responsible parties quarterly and annually to Mass Health.
• Submits changes in residents’ social security and pension amounts to Mass Health.
• Receives funds from residents and families, disburses funds and records transactions.
• Counts money to verify amounts and issues receipts for funds received.
• Meet with families about PPA changes, re-determinations and Mass Health applications as needed.
• Assist families with re-determination issues and asset verification requests and follow up on late or incomplete re-determinations.
• Assist in gathering information for internal, state and federal audits as necessary.
• Complete preparation of private billing and other billing as directed and as necessary.
• Assist in ancillary services billing as needed.
• Completes cash application for all resident cash receipts.
• Prepare deposit sheets for bank deposit
• Enter deposited payments to resident A/R accounts

Other Responsibilities

Adheres to the Standards of Conduct which is the basis of the Organizational Integrity Program.

Compliance with Health Information Privacy (HIPPA) related laws and regulations.

MISSION AND QUALITY STATEMENTS:

MISSION:

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Demonstrates the philosophy, mission and core values of Compassion, Integrity, Collaboration and Excellence of Mary Immaculate Health/Care Services in the performance of one's job responsibilities. This includes:

a) courteous and cooperative behavior toward co-workers, residents, tenants and/or participants, families and guests; and

b) a positive and professional attitude while providing care to residents, tenants and/or participants and in all interactions with co-workers.

Participates in, promotes and supports Mission activities.

QUALITY:

• Assumes responsibility for the highest level of quality performance in all aspect's of ones job
• Performs each task in compliance with facility policies and procedures
• Makes decisions based on what is best for the residents, tenants, and/or participants and their families

Competency

To perform the job successfully, an individual should demonstrate the following competencies:

Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations

Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification

Written Communication - Writes clearly and informatively; Presents numerical data effectively; Able to read and interpret written information.

Teamwork - Balances team and individual responsibilities

Ethics - Works with integrity and ethically; Upholds organizational values.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Skills & Experience

Associate degree in finance, accounting or business preferred. High School Diploma required. Two plus years’ experience in a long term care setting or combination of education and experience, strong mathematical and analytical skills, knowledge of Microsoft office products and accounting software. Ability to multitask in a fast paced environment. Excellent customer service skills with the ability to work effectively with a diverse population. Possess strong verbal and written communication skills. Ability to speak Spanish a plus.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel and talk or hear. The employee is frequently required to stand; walk and sit. The employee is occasionally required to reach with hands and arms and stoop, kneel, crouch, or crawl. The employee may lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision and ability to adjust focus.

Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Covenant Health Mission Statement

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Our Core Values:

Compassion

We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

Integrity

We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

Collaboration

We work in partnership, dialogue and shared purpose to create healthy communities.

Excellence

We deliver all services with the highest level of quality, while seeking creative innovation.

We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.

Job Type: Part-time

Expected hours: 24 – 28 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience level:

• 2 years

Schedule:

• Day shift

Experience:

• Finance: 1 year (Preferred)
• Medical billing: 1 year (Preferred)

Ability to Commute:

• Cumberland, RI 02864 (Required)

Work Location: In person