• Business Services Supervisor

  • St. Mary's Nursing and Rehabilitation Center
  • Leonardtown, Maryland
Job Summary
Employment Type
Full Time
Years Experience
1 - 3 years
Salary
$65,000 - $75,000 Annual
Benefit Insights
Health Insurance
Flexible Schedules
401(k)
Health Savings Accounts (HSAs)
Medical Flexible Spending Account
Life Insurance
Dental Insurance
Vision Insurance
Job Description

Position Summary: Responsible for enterprise-level patient/resident billing that expands to Assisted Living and Skilled Nursing (Healthcare) divisions. Inclusive of primary medical billing, secondary medical billing, and all ancillary patient / resident expense items.

Supervise accounts receivable, accounts payable, and billing functions and monitor the status of same.

Supervisory:

  • Business Services Representative & Accounts Payable Administrator


Essential Duties:

  • Responsible for enterprise-level patient/resident billing that expands to Assisted Living and Skilled Nursing (Healthcare) divisions. Inclusive of primary medical billing, secondary medical billing, and all ancillary patient / resident expense items.
  • Performs Daily Census Reconciliation.
  • Responsible for preparing Medicare Part A, Medicare Part B, Third Party Insurance, Medicaid, and Private Pay billing. Responsible for organizing Medicare appeals and all correspondence for Medicare and insurance issues.
  • Creates and implement policies and procedures for all aspects of patient/resident billing.
  • Stays abreast of changes in legislation and updates to laws and compliance regulations of Medicaid and Medicare.
  • Ensures recertification of insurance contracts which will include Medicare Recertification.
  • Creates and manages all Medicaid applications, including,
  • The startup process -contacting the resident’s family, discussing the process, and obtaining all requirement documentation.
  • Keeping track of application completion and assisting families with the application process
  • Following up with the Medicaid representative on the application status
  • Submitting additional information to Maryland Medicaid as requested.
  • Submitting a redetermination, annually, on all Medicaid residents.
  • Audits claims for completeness and accuracy prior to submitting to ensure clean claims.
  • Performs collection calls to resident’s representative for residents’ private resources due.
  • Accurately transmits electronically claims for Medicaid and Medicare billing each month in a timely manner.
  • Maintains Medicaid and Medicare Logs and other Cost Reports related schedules including preparation of Credit Balance Reports.
  • Creates and submits coinsurance claims with EOBs attached once Medicaid and Medicare payments arrive. Maintains Medicaid co-insurance write-off log (65/35).
  • Immediately notifies CFO and Administrator of audits, Office of Attorney General Notifications, Medical, or Legal authorities which includes IRS and any other regulatory or legal agency.
  • Ensures all returned claims are reviewed and corrected on a daily basis.
  • Recognize problem accounts and notify Controller/CFO to assist in problem-solving.
  • Monitors Accounts Receivable for unpaid claims and follows up with phone calls, contacting insurance companies to work through denials, etc. in accordance with collection policies.
  • Generates total billing figures and balances to the census.
  • Prepares monthly explanations of accounts over 30 days past due for Controller/CFO. Takes appropriate action to collect all monies owed to St. Mary’s Nursing Center, and keeps Controller/CFO informed of any collection problems.
  • Maintains the strictest confidentiality; adheres to all HIPAA guidelines and regulations,
  • Attends and participates in continuing educational programs.
  • Attends committee meetings as requested.
  • Consistently displays professionalism and promptness in dealing with residents, responsible parties, other departments, and regulatory entities when resolving billing issues.
  • Performs other duties as assigned by the Controller / CFO.


Key Competencies:

  • Advanced knowledge of the laws, regulations and guidelines that pertain to Long-Term Care and Medicare billing guidelines and Medicaid Billing Guidelines.
  • Knowledge of accounts receivable billing and collections computer programs.
  • Knowledge of the principles, practices, and regulations of long-term care.
  • Must have the ability to understand and interpret policies and procedures.
  • Ability to establish and maintain effective working relationships with residents, responsible parties, coworkers, insurance companies, and government agencies/personnel.
  • Advanced knowledge of Microsoft Office Suite, Outlook, and researching utilizing the internet.
  • Must be capable of handling complex situations with residents and family members.
  • Must be able to maintain the highest level of confidentiality regarding resident-related information.
  • Must be able to meet the standards of the St. Mary’s Nursing Center.

Minimum Qualifications:

A high school diploma or equivalent is required. Must have a minimum of five years of medical billing experience preferably in a healthcare environment and long-term care.

Work Environment:

  • Must be able to sit for extended periods of time throughout the work day.
  • Must be able to relate to and work with ill, disabled, elderly, emotionally upset, and, at times hostile individuals within the facility.
  • Must be able to lift, push, pull and move a minimum of thirty (30) pounds.
  • Must be able to assist in the evacuation of residents.
  • Sits stands, bends, lifts and moves intermittently during working hours.
  • Works beyond normal working hours as needed.

 

 

 

 

 

Job ID: 362630869