LTC Billing Specialist

Job Description

JOB SUMMARY:

The LTC Billing Specialist is responsible for the billing, collection and posting of LTC revenue to expedite reimbursement for charges and expenses. Work is performed in accordance with Federal, state and local standards, guidelines and regulations that govern long-term care facilities, and under the supervision of the LTC Finance Supervisor.

ESSENTIAL FUNCTIONS:

Be a member of the SNF revenue cycle team

• Work in a team-friendly environment.
• Maintain up-to-date knowledge of SNF reimbursement including Medicare and Medicaid (PA DHS, PA CHCs (AmeriHealth Caritas/Keystone First, PA Health & Wellness, UPMC HealthChoices)) and all other facets that pertain to the SNF.
• Maintains specific processes for the collection and maintenance of resident data including, but not limited to resident statement accuracy, review of resident aging, payment posting, ancillary charge entry and file downloads and timely billing.
• Assists with managing all accounts receivable accounts including follow-up of unpaid balances.
• Adherence to all financial/facility policies and procedures and participates in facility programs as needed.
• Assists with troubleshooting hardware and software issues.
• Maintain adequate documentation of all accounts receivable accounting transactions.
• Assists with the month end close process. Provides facility representative monthly financial information. Prepare monthly accounts receivable reports as directed for facility. Provide additional reports as requested.
• Participation in continuing education programs designed to keep abreast of changes in SNF reimbursement.
• Assist/participate in establishing corporate compliance programs (Triple Check, etc.).

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

• Associate’s degree in accounting or business-related field preferred. Experience in lieu of a degree may be accepted.

Work Experience

• Currently in billing position with 2+ years SNF specific billing experience in PA
• 2+ years of experience in SNF Medicare and Medicaid billing required with knowledge of LTC billing regulations for Medicare and Medicaid.
• PointClick Care (PCC) of direct billing in software system.
• Experience with utilizing clearinghouses (Quadax preferred).
• Experience using the Medicare system for billing and the ability to interpret reports and remits.
• Knowledge and experience using Medicaid systems and websites.
• Working knowledge of SNF billing and collections.
• Position subject to Criminal Background Investigation.

Licenses / Certifications

• N/A