Medical Billing Coordinator Full-Time in Lakeland, Florida at Estates at Carpenters

General Information

Official Job Title: Medical Billing Specialist

Department: Business Office

Reports To: Business Office Manager

FLSA Status: Non-Exempt

Job Type: Regular Full Time

Eligible For Benefits: Yes

Job Objective/ Summary

The responsibility of a Medical Billing Specialist is data collection and processing monthly billings to Medicare Part A and Part B, Secondary Insurances, HMO’s, Medicaid, and data gathering as required.

Essential Functions

• Adhere to policies and procedures that govern the accounting and medical billing functions of the facility.
• Participate in departmental meetings.
• Attend Medicare meeting with Nursing Home staff for daily updates on the Medicare residents.
• Assist in standardizing the methods in which work will be accomplished.
• Monitor the aging of accounts and implement collection procedures as needed. Report delinquent accounts to Administration and the Business Office Manager.
• Monitor and collect accounts receivable, including the processing of resident billings, statements and collections.
• Prepare financial and statistical reports as required.
• Handle issues and problems as they arise.
• Develop and utilize computer reports and output as required.
• Ensure that resident admission contracts are signed timely and appropriately filed.
• Verify Medicare and Supplement insurance coverage for admissions in the nursing home and out-patient therapy.
• Process all charges and monthly statements for nursing home including therapy logs, ancillaries, supplies, etc.
• Process monthly Medicare Part A and Part B billing for all residents and track for payments.
• Process third-party billing to Medicare and co-insurance companies. Monitor the aging and adjust as needed for Medicare adjustments, overpayments, etc.
• Communicate with Residents, Family Members, and Responsible Parties regarding contract, insurance or billing concerns. Respond to questions and concerns as they arise and assist in educating all parties on billing/accounting procedures.
• Maintain Resident Financial files to State Survey standards.
• Maintain Resident Personal Use accounts for healthcare residents as needed. Maintain compliance with regulations concerning the management of and accounting for Resident Personal Funds. Maintain the bank account and complete the monthly bank reconciliation.
• File for monthly Medicaid payment for nursing home Residents. Monitor coverage for all approved Residents and their patient responsibility. Maintain facility Medicaid Per Diem rates.
• Track daily Resident census for all pay categories for each facility and keep corresponding weekly, monthly and annual reports.
• Agree not to disclose assigned user ID code and password for accessing resident/facility information and promptly report suspected or known violations of such disclosure to the Administrator.
• Agree not to disclose resident’s protected health information and promptly report suspected or known violations of such disclosure to the Administrator.
• Prepare all spreadsheets, reports and files for annual auditors and as requested.
• Report any known or suspected unauthorized attempt to access facility’s information system.
• Follow all Quality Assurance standards and established departmental procedures as developed by the Director of Finance. Meet or exceed established thresholds.
• Assist co-workers when all tasks are completed, or as instructed by the Business Office Manager.

Other Duties & Responsibilities

• Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position. Attends and participates in orientation, training and educational activities as required

Qualifications and Job Requirements

Job Education, Licenses/Certifications, Knowledge & Experience

• Must, at a minimum, be a high school graduate or have the GED equivalent.
• Two (2) years’ experience as a Skilled Nursing Facility bookkeeper; billing Medicare, Secondary Insurances, HMO’s and Medicaid is preferred.

• Must be able to read, write, speak, and understand the English language.
• Must possess the ability to make independent decisions when circumstances warrant such action.
• Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel and the general public.
• Must be knowledgeable of regulations relating to Medicare Part A and Part B, Secondary Insurances, HMOs, VA, and Medicaid.
• Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies, and procedures, etc., that are necessary for the position.
• Must be knowledgeable of computers, data entry/retrieval, output, system applications, etc.
• Must be knowledgeable of principles of accounting, including cost reporting.
• Must not pose a direct threat to the health or safety of other individuals in the workplace.
• Must have knowledge of office machines, equipment, and procedures.
• Must be able to type a minimum of 45 words per minute and be knowledgeable of computers/programs.
• Must possess specific knowledge of Microsoft Word and Excel

Requirements

• Must successfully pass the mandated criminal background checks. (https://info.flclearinghouse.com)
• Must be able to pass a pre-employment drug screen.
• Must be able to pass the pre-employment reference checks.
• Must be able to provide official grade transcripts of the education level provided on the employment application.
• Must be able to provide a copy of his/her own social security card for W-4 documentation.
• Must be able to provide applicable documentation(s) for I-9 in order to establish identity and authorization to work in the U.S.

Bloodborne Pathogens Exposure Category II

Your tasks involve no routine exposure to blood, body fluids, tissues, or other contaminated materials. In the event of an unexpected blood, body fluid or tissue spill there will be an employee available who has been designated to take responsibility for clean-up and decontamination of potentially infectious body substances. You are not to come in contact with potentially infectious body substances.

Physical Requirements and Working Conditions

While performing the duties of this position, a Human Resources Assistant is regularly required to sit, talk, hear and walk. This role may require bending, kneeling, reaching and lifting a minimum of 10lbs.

Note: This job description is representative of the major position requirements and is not intended to be all-inclusive.

Statement of Understanding

I have read the above job description and understand the responsibilities and physical demands of the job. I hereby certify that I am able to perform all the essential job functions described above, with or without reasonable accommodation.

I also understand that my job duties in such position may change as deemed necessary by The Estates at Carpenters in its sole discretion. I do not have a contractual “right” to work only the job described above.

I further understand that my employment in the position described above will be “at-will,” meaning that either I or The Estates at Carpenters may terminate the employment at any time, with or without notice and with or without cause. I understand and agree that no agent or employee of The Estates at Carpenters is authorized to modify the at-will nature of my employment except the Executive Director and that any such modification must be in writing and be signed by the Executive Director to be binding.