Managed Care Biller

Description

Job Summary:

The Managed Care/Medicare Billing Specialist has the responsibility for managing the accounts receivable, billing and collection related functions for multiple Skilled Nursing facilities in the state of Texas. Focus will be on the managed care/Medicare revenue cycle in order to optimize revenue, improve cash flow and strengthen the company’s financial position. This position will be responsible for managed care and Medicare claims.

Qualifications

Qualifications:

• A high school diploma is required, a college degree or equivalent advanced courses are preferred.
• Prior managed care/Medicare skilled nursing facility billing experience required.
• Strong knowledge of billing software (American Health Tech and/or HealthMedX Vision software experience preferred).
• Ability to multitask, meet deadlines and prioritize workload.
• Highly motivated, organized and detail oriented individual with good interpersonal and communication skills.
• Strong team player with willingness to help in other areas of medical billing

Essential Functions:

• Processes monthly billing for managed care claims and Medicare Part A services.
• Claims creation and working denials.
• ICD 9 and ICD 10 understanding.
• Verifying Medicare eligibility and coverage days available.
• Payment posting.
• Answering provider questions.
• Ensure billing is accurate, complete and in compliance with State and Federal regulations.
• Coordinate third party billing with nursing facility personnel as necessary. 
• Communicates and works in cooperation with fiscal intermediaries, accountants, auditors, cost report preparers, state and federal agencies and private insurance companies.
• Monitors facility receivable balances and maintains receivable balances within acceptable limits, as well as, assists with collection of problem accounts.
• Understand billing software capabilities and lead efforts to enhance efficiencies.
• Understand software and regulatory requirements for transmitting claims to the various third party payers.
• Analyze and resolve technical questions regarding billing including transmission to payers, calculating claims, printing bills, resident accounts, etc.
• Ensure all required billing compliance and regulatory initiative are met.
• Compiles and prepares data and reports as required.
• Strives to meet company DSO and collection goals every month.
• Ensures compliance with Cantex policies and procedures including Financial Management Systems.
• Performs other duties and tasks as assigned by the AR Manager, Director of Finance or CFO.

Please visit cantexcc.com for more information on this location.

We are an Equal opportunity employer; We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.

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