Medicaid/Medicare Billing - Community

**Now Offering DailyPay**

Overview

Summary:      

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Verify Medicaid and Medicaid waiver residents census and add payers
• Verify Rehab Stay census & attach payers
• Medicaid application
• Authorized representative for family and Otterbein and send in documents needed
• Field FSSA phone interview and letter with request
• Process monthly Medicaid billing with the State and all 3 MCE’s
• Process all monthly Medicare insurance billing
• Monitor DDE system daily for Medicare claims status—make corrections and adjust.
• Submit no pay claims
• Private billing statements for SNF
• Monitor all past due balances and contact responsible party for collection
• Verify MCD eligibility for each resident on website for the month prior to billing
• Prepare and track deviation bills for Medicaid residents who have old private balances
• Bill and track Co-insurance claims
• Prepare liability spread sheet with current liability or changes
• Assist with Medicaid back billing on a computerized system
• Follow up for Medicaid accounts – letters to families, phone calls to facilities that were former locations of Medicaid Residents
• Enter in-house receipts from deposit for SNF
• Assist with audits
• Perform various other accounts receivable functions as assigned.
• Work with all three MCE’s on Medicaid claims through Availity & UHC website
• Track bad debt log for Medicaid—Medicare Co-Insurance with no supplement & submit annually.
• Work with Hospice Companies to get claims paid
• PASRR—send level of care to be updated in MCD system so we will get paid.
• Perform various other accounts receivable functions as assigned.

Competencies:  To perform the job successfully, an individual should demonstrate the following competencies:  Customer Service - Respond to requests for service and assistance.  Interpersonal Skills - Maintain confidentiality.  Written Communication - Edit work for spelling and grammar. Professionalism - Approach others in a tactful manner.  Attendance/Punctuality - Ensure work responsibilities are covered when absent.                        

Qualifications:  To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience:  High School diploma or general education degree (GED), or one to three months’ related experience and/or training, or equivalent combination of education and experience.  Completion of high school courses in typing, bookkeeping and other business subjects.  One to two years additional course work in accounting or bookkeeping at college or equivalent work experience.  At least one year of accounting/bookkeeping experience with emphasis in accounts receivable.  Some experience with computerized accounting systems desirable.  Employee must participate in orientation training, attend mandatory in-services, and/or other department specified training in-services.

Computer Skills:  To perform this job successfully, an individual must be able to use the Community’s computerized time clock system.  Employee should have knowledge of Microsoft Word, Outlook, and Excel Processing software, the internet, and have ability and willingness to learn and use, if any, other software applications pertaining to this position.

BENEFITS*

• Medical insurance with free virtual doctor visits
• Vision and dental insurance
• Paid Time off that accrues immediately
• Paid Holidays
• Life insurance
• Retirements Savings with a 401(k) or 403(b) with company match
• Access up to 100% of your net earned based wages daily through DailyPay
• Employee sponsored fund for employees in need
• Employee Assistance Program (EAP)
• Tuition Assistance

*Some benefits are based on hours worked