Billing Representative

GENERAL PURPOSE

To perform and/or oversee the successful and timely completion of all business and financial functions within the parameters established by the client guidelines, state and federal regulations, and as needed to achieve the financial goals of the facility. Promote an environment that provides optimal efficiencies and superior quality of the business office.

QUALIFICATIONS

• High school diploma or equivalent
• Knowledge of Medicare, Medicaid, Prescription Drug Plans (PDP’s) and Third Party Insurances.
• Healthcare/Pharmacy billing and collection experience preferred
• Strong organization skills including the ability to prioritize and manage multiple tasks in a dynamic environment
• Strong analytical skills; ability to quickly identify problems and find effective solutions
• Strong written and oral communication skills
• Must have knowledge of office machines and equipment
• Basic computer skills preferred; experience with Microsoft Excel and Word
• Ability to make independent decisions.
• Ability to understand and interpret financial data.
• Ability to work and produce results under pressure
• Ability to effectively and harmoniously interact with facility, management and other employees at all levels; promotes teamwork and professionalism
• Must be capable of maintaining regular attendance
• Must be dependable and able to work with minimal supervision
• Must be at least 18 years of age
• Must be able to speak, read, write, and understand English
• Must be capable of performing the ESSENTIAL JOB FUNCTIONS and PHYSICAL AND SENSORY REQUIREMENTS FOR ALL JOB FUNCTIONS as outlined below.

STANDARD REQUIREMENTS

• Maintains confidentiality of all patient and/or employee information to assure patient and/or employee rights are protected.
• Support the Mission, Values, and Vision of the client.
• Report to Management immediately all instances of misappropriation/handling of company resources.
• Support, cooperate with, and implement specific procedures and programs for:

- Maintaining confidentiality of all data, including resident, employee, and operations data.

- Safety and safe work practices, established fire/safety/disaster plans, risk management, and security, report and/or correct unsafe working conditions, equipment repair and maintenance needs.

- Compliance with all regulatory requirements

- Compliance with current law and policy to provide a work environment free from harassment, and all illegal and discriminatory behavior.

• Support and participate in common teamwork:

- Cooperate and work together with all co-workers; plan and complete job duties with minimal supervisory direction, including appropriate judgment.

- Use tactful, appropriate communications in sensitive and emotional situations.

- Follow up as appropriate with supervisor, co-workers or residents regarding reported complaints, problems, and concerns.

- Promote positive public relations with residents and family members.

- Complete requirements for in-service training, acceptable attendance, uniform and dress codes including personal hygiene, and other work duties as assigned.

• Provide great customer service to internal and external customers:

- Promote positive public relations with residents, family members, and guests.

- Support the client in a friendly, courteous, and cooperative manner.

• Comply with all company policies and procedures regarding HIPAA Privacy and Security.

ESSENTIAL JOB FUNCTIONS

• Performs and/or oversees the completion of all routine and tasks, including but not limited to:

- Obtains and inputs patient admission information including insurance data for billing purposes both timely and accurately.

- Processes welcome letters and/or welcome calls on all new admissions.

- Manages claim rejections.

- Maintains current census and account information to reflect up-to-date and accurate information.

- Assists with answering the telephones.

- Conducts collection of accounts receivable and past due accounts according to the collection policy.

- Process Write-off requests when necessary according to the collection policy.

- Performs audits on resident accounts to ensure accurate billing.

- Process account re-bills in a prompt, thorough and accurate manner and processes corresponding accounts receivable credit requests when necessary.

- Provides prompt and courteous service to all customers and patients.

- Address correction on returned mail

- Responsible for courteously and effectively resolving billing inquiries from facilities, sponsors or other responsible parties.

- Posts charges, credits and payments in computer system when required.

- Process Facility and Private pay billing when required.

- Process Third party billing when required.

- Prepares private and facility statements/invoices for delivery when required.

- Answer/return phone calls in a timely manner

• Reviews, analyzes and interprets data to monitor progress toward established goals; identifies deterrents to success and implements improvements as necessary to enhance efficiencies and results; facilitates effective problem resolution and development of business office goals and objectives.
• Accepts ownership and accountability for the successful completion of assigned functions and achievement of goals.
• Strives for compliance by all staff with internal controls and state and federal regulations.
• Participates in the development and successful implementation of plan(s) of improvement as indicated, recommended and/or required by Supervisor, Director, or any other corporate or regulatory compliance consultant. Communicates progress toward goals and ongoing obstacles to supervisor and company management team, verbally and/or in writing or as dictated.
• Provides training to other staff that is necessary to successful job performance, consistent with company standards and expectations, and facilitates cross-functional awareness and proficiencies.

OTHER JOB FUNCTIONS

• Performs all other duties as assigned by supervisor.

COMPLIANCE

• Complies with all Quality Assurance, Policies and Procedures and regulatory requirements including but not limited to those within the HIPAA, Privacy, Compliance process and Code of Conduct.
• Report concerns and suspected incidences of non-compliance using chain of command, hotline number or compliance representative.
• Cooperate with independent monitoring and auditing functions
• Cooperate with independent investigations as requested
• Participate in quality improvement processes as requested

Training

• Complete requirement of education training annually

WORKING CONDITIONS

• Interact with residents, family members, staff, visitors, government agencies / personnel, etc. under all conditions / circumstances.
• May be subject to hostile and emotionally upset residents, family members, staff, visitors, etc., under all conditions / circumstances.
• May be subject to frustrations in meeting work demands due to frequent interruptions.

PHYSICAL AND SENSORY REQUIREMENTS FOR ALL JOB FUNCTIONS

• Mobility within work environment necessary to perform job duties.
• Ability to lift, carry, push, bend, reach, grasp, perform fine manipulations, etc., necessary to perform job duties.
• Ability to remain calm under stress.
• Ability to communicate with residents, families, personnel and support agencies.
• Ability to evaluate and interpret information.

Job Type: Full-time

Pay: $17.00 per hour

Work Location: In person

Salary : $17