We are seeking a detail-oriented individual with proficiency in Excel to join our team. The ideal candidate will possess strong analytical and problem-solving skills to investigate and resolve various issues such as discrepancies, denials, appeals, and collections. The ability to work both independently and collaboratively within a team is essential, along with the capacity to follow directions and complete tasks promptly. Maintaining strict confidentiality is paramount in this role, so discretion is a must. Excellent organizational, interpersonal, and time management skills are crucial for success. Moreover, the candidate should demonstrate exceptional customer service and communication abilities to interact effectively with residents, family members, and communities. Sensitivity to the unique needs of older adults is highly valued in this position.

Performs and coordinates Medicare/third-party billing for assigned Vi CCRCs. Assures compliance with Medicare/Medicaid accounting procedures and regulations and files in an accurate and timely manner to achieve maximum reimbursement potential. Performs other duties as assigned.

• Processes accurate Primary, Secondary, and Tertiary claims.
• Verifies Primary and Secondary Insurances for Medicare B Residents.
• Works with communities to ensure proper compliance, accuracy of charges and completeness of data.
• Completes and submits claims in a timely manner for Primary, Secondary, and Tertiary claims.
• Follows up on claim status.
• Prepares Medicare, Medicaid and other insurances refunds.
• Handles re-bills, denials and appeals.
• Processes Medicare charges (Therapy, Pharmacy, Medical supplies, Consolidated Billing,
  x-ray, labs, etc.).
• Reports status of accounts to Director of Central Billing Office on a monthly basis.
• Collaborates with community staff to resolve billing problems with claims.
• Communicates status of Medicare and third-party claims to appropriate Community staff as needed.
• Responsible for posting third party deposits and resolving any underpayments at time of cash posting.
• Maintains an organized filing system.
• Adheres to all Medicare policies and procedures.
• Remains current with regulations and updates job knowledge by participating in educational opportunities.
• Maintains resident confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Safeguards the company assets by ensuring all internal controls are strictly adhered to.