What are the responsibilities and job description for the Medicare Corporate Biller position at Optalis Health and Rehabilitation?
Overview
The Corporate Biller accurately bills payers to assure timely payments of services provided, follows up on unpaid claims and audits accounts as necessary to resolve balances. Additionally, the Corporate Biller will provide assistance to the Corporate Billing Manager as requested.
Essential Functions and Responsibilities
To perform this job successfully, an individual must be able to perform each key function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the key functions.
Responsibility
The billing coordinator will be responsible for maintaining the following:
- Responsible for billing and collections of assigned payers.
- Understand the terms of managed care/hospice (BCBS 5th Level and Medicaid) contracts and bill in accordance with these terms.
- Review admissions weekly to assure data is properly inputted in the accounting system for proper billing.
- Accurately posts all cash.
- Follows up daily on receivables outstanding and responds to requests for information and denials in a timely manner.
- Maintains up to date knowledge of how to bill ALL commercial insurances, managed care, Medicare PPO, HMO, advantage plans, auto claims, worker's compensation claims, Medicaid HMO and managed Medicaid plans.
- Accurately bills coinsurance and copay amounts; adjust account balances in accounting system appropriately.
- Addresses and is able to explain Explanations of Benefits, co-pays and deductibles.
- Conducts data entry for month end billing. Completes month end processes timely.
- Inservice business office staff as needed.
- Effectively manages time to meet deadlines.
- Direct involvement in accounts receivable collections process, including responsibility for pursuit of delinquent accounts.
- Responsibility for completing external reports for third parties as assigned.
- Participation in relevant in-service training sessions.
- Attendance and participation in relevant facility meetings
- Develop a working knowledge of all emergency and disaster procedures of the facility.
- Willingness to perform other duties as assigned, including various clerical duties as they are necessary.
Qualifications
- Education or experience with accounting functions, including accounts payable, billing, accounts receivable, collections, and bank reconciliations. A degree is preferred, but not required with significant relevant experience.
- Specialized training in Medicare and Insurance billing preferred
- At least two years long term care billing experience
- Working knowledge of third-party insurers
- Working knowledge of the department of Human Services
- Understands and has worked with Availity and similar programs
- Understands process of Medicaid Applications
- Understands Medicare Eligibility
- Understands Michigan MI Health
- Experience with collection calls and follow up documentation.
- Strong organizational skills, including managing the outcomes of others, and the ability to effectively multi task.
- Possesses strong interpersonal skills, including communication with supervisors, other staff and managers in the facility, vendors, and effective communication with residents and family members.
- Ability to effectively manage outcomes of this position as well as the outcomes of others in an environment of accountability.
- Effective user of technology, including personal computer and software applications in job functions. Examples include Microsoft Outlook, Email, Word, Excel, Internet, and use of billing and accounting software.
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