What are the responsibilities and job description for the Regional Billing Specialist position at Apple Rehab?
Apple Rehab is a family owned and operated company that treats residents and staff like family too. Our expert team of senior management is located at our home office, right in Avon, CT, ensuring superior care from a local company. Our leadership is not across the country, but rather in your backyard.
Reports to Director of Accounts Receivable.
Focused billing of Medicare claims to ensure payment within 14 days. Billing of assigned Medicare Secondary Payer claims and Managed Care claims for payment within 45 days.
Attends AR Reviews as requested and reviews aging reports regularly to ensure balances are paid and adjustments needed are posted timely until balances are resolved to zero.
Submits electronic claims for Medicare coinsurance as needed. Adjusts any Managed Care coinsurance claims to second payer and follows through on billing Medicaid. Forwards EOB to facility staff to send with private statement if needed.
Completes 210 submissions for non-skilled, benefits exhaust, no QHS for Medicaid pay starts as assigned.
Identifies trends in denials/underpayments, and initiate appeals when necessary.
Acts as a subject matter expert and provides training to staff as required.
Prepares regular billing summaries, outstanding AR reports, and cash flow updates.
Documents all collection efforts and actions taken in billing software regularly as required.
Completes special reports and projects when assigned.
Required Qualifications
Over 5 years of billing and collections experience specific to skilled nursing facilities.
Must have thorough knowledge of Medicare and Managed Care billing and reimbursement regulations for skilled nursing and long-term care.
Must have thorough knowledge of Medicaid pay start requirements and procedures.
Strong communication skills and ability to work well in a high-pressure environment, handle multiple priorities and work independently.
Must have strong working knowledge of electronic claims submission, FISS DDE and Point Click Care.
IND123
Reports to Director of Accounts Receivable.
Focused billing of Medicare claims to ensure payment within 14 days. Billing of assigned Medicare Secondary Payer claims and Managed Care claims for payment within 45 days.
Attends AR Reviews as requested and reviews aging reports regularly to ensure balances are paid and adjustments needed are posted timely until balances are resolved to zero.
Submits electronic claims for Medicare coinsurance as needed. Adjusts any Managed Care coinsurance claims to second payer and follows through on billing Medicaid. Forwards EOB to facility staff to send with private statement if needed.
Completes 210 submissions for non-skilled, benefits exhaust, no QHS for Medicaid pay starts as assigned.
Identifies trends in denials/underpayments, and initiate appeals when necessary.
Acts as a subject matter expert and provides training to staff as required.
Prepares regular billing summaries, outstanding AR reports, and cash flow updates.
Documents all collection efforts and actions taken in billing software regularly as required.
Completes special reports and projects when assigned.
Required Qualifications
Over 5 years of billing and collections experience specific to skilled nursing facilities.
Must have thorough knowledge of Medicare and Managed Care billing and reimbursement regulations for skilled nursing and long-term care.
Must have thorough knowledge of Medicaid pay start requirements and procedures.
Strong communication skills and ability to work well in a high-pressure environment, handle multiple priorities and work independently.
Must have strong working knowledge of electronic claims submission, FISS DDE and Point Click Care.
IND123