What are the responsibilities and job description for the MCO Biller position at ALIYA Healthcare?
Position Summary
The MCO Biller is responsible for managing all Managed Medicare, Commercial and Managed Medicaid billing functions for the facility. This role ensures accurate, timely submission of claims, resolves denials, verifies coverage, and works closely with clinical and administrative staff to ensure proper documentation and reimbursement.
Key Responsibilities
- Prepare, review, and submit claims accurately and on time.
- Verify resident insurance coverage, benefits, and authorizations.
- Monitor and work rejected and denied claims, following up promptly to secure payment.
- Collaborate with Nursing, MDS, and Admissions to ensure accuracy of billing-related documentation.
- Track and manage coverage periods, authorizations, and eligibility updates.
- Maintain organized billing records and protect resident confidentiality.
- Communicate with payers, families, and internal departments regarding billing questions.
Benefits
- Medical, Dental, Vision Insurance
- Flexible Spending Account (FSA)
- Life and Critical Illness Insurance
- Short-Term Disability
- Accident and Hospital Indemnity Insurance
- 401(k) Retirement Plan
- On-Demand Pay
- Paid Time Off (PTO)
Qualifications
- High school diploma or equivalent required
- Experience in SNF billing is preferred.
- Excellent attention to detail, accuracy, and follow-through.
- Strong communication and problem-solving skills.
- Ability to work independently and manage deadlines.
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