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Billing and Collections Specialist - Our Lady of Peace in Niagara Falls, NY at Ascension Living

Date Posted: 2/20/2019

Job Snapshot

Job Description


Under the direction of the Regional Manager, Billing and Collections, this position is responsible for maintaining accounts receivables related to Third Party Insurances, which includes timely and accurate billing for services provided, collection of accounts receivable, claims submission to all payers and month-end processing. PRINCIPAL DUTIES AND RESPONSIBILITIES  Responsible for accurate and timely billing of Third Party Insurance Claims and A/R followup as assigned, including, but not limited to:  Medicare A & B  Managed Care/Private Insurance  Medicaid/PACE  Third Party Coinsurance  Maintain documentation to support third party claims submission and collections in accordance with defined policies.  Manage A/R collections through claims submission, adjustments, phone calls, and appeals as needed on assigned communities, to meet and/or reduce day’s sales outstanding goals as established by the Senior Director of Revenue Cycle Management.  Maintain A/R notes in the billing software with all outstanding A/R balances reviewed at minimum every 30 days.  Prepare documentation/collection notes for monthly accounts receivable reviews with Regional Manager, Billing and Collections and Senior Director of Revenue Cycle Management.  Identify, document, and communicate best practices and process improvement opportunities to Regional Manager, Billing and Collections.  Assist with cash posting as needed on assigned communities.  Provide back-up and cross-training to other associates in the Billing and Collections organization.  Remain up to date on CMS regulations and policies, as well as federal and state regulations and policies related to healthcare, long term care facilities, and insurance.  Prepare documentation for approval of A/R adjustments including, but not limited to:  Contractual Adjustments  Charity Adjustments  Bad Debt Write Offs  Administrative Adjustments  Insurance Refunds  Maintain the monthly Medicare Bad Debt log for dual eligible and other accounts, with supporting documentation, to be approved for write off by the Regional Manager, Billing and Collections.  Maintain ongoing metrics for the Regional Manager, Billing and Collections and the Senior Director of Revenue Cycle Management to provide continual self-assessment of performance and identification of process improvement opportunities.  Attend and actively participate in Revenue Cycle, Central Billing Team trainings and meetings.  Other duties as assigned.

Job Requirements

EDUCATION AND/OR EXPERIENCE  High School Graduate or GED. Associate Degree in Accounting or Business preferred.  Minimum of 3 years of Accounts Receivable processing experience.  Education or experience in third party reimbursement billing, collections, and compliance assurance for skilled nursing facilities including Medicare, Medicaid, Managed Care and Coinsurance preferred.  Ability to define problems, analyze data, establish facts, and draw valid conclusions.  Ability to read and interpret documents such as CMS regulations, Managed Care contracts and other instructions and procedure manuals. Ability to speak effectively before administrators, residents or employees.