Administrative Specialist

Job Description

Job Description

EATON COUNTY HEALTH & REHABILITATION SERVICES

JOB DESCRIPTION

TITLE: Administrative Specialist STATUS: Non-Exempt

DEPARTMENT: Administration REPORTS TO: Reimbursement Director

Job Summary:

Ensures timely and accurate accounts receivable and billing functions while working closely with the outside billing company, Reimbursement Director, and CEO.

Principal Duties and Responsibilities:

Performs the following duties listed and others as required to improve the functions of the AR Department. Duties and responsibilities may be modified at any time.

• Responsible for verifying and entering Medicaid therapy authorizations into CHAMPS.
• Responsible for entering into CHAMPS admissions and discharges for Medicaid residents.
• Responsible for coordination of completing the Level of Care Determination for Medicaid residents through completing the LOCD audit and reviewing CHAMPs.
• Works with DHS, residents and families complete and submit Medicaid applications and annual renewals in a timely manner.
• Works with DHS, residents and families complete the Home Maintenance Disregard (HMD) as appropriate.
• Responsible for coordinating with the DHS to complete Long Term Care Financial reviews for new admissions and residents requesting to stay for long term care.
• Responsible for ensuring payments of Medicaid patient pay amounts and related collection activities.
• Responsible for maintaining a "real time" census in the billing system, including entering new admissions, discharges, room and payor changes, etc.
• Resolves resident/family members Medicaid related billing questions.
• Provide coverage of Administrative Services positions for lunch breaks, vacation time, etc. including but not limited to answering phones and waiting on customers/vendors.
• Responsible for checking, responding and communicating via emails daily.

• Familiarize with "Stop & Watch", sending alerts, charting behaviors.
• Complete monthly in-services and attend face to face in-services as required.

• Coordination of 360 Care and answering family/resident questions related to such.
• Performs other duties and related work as required. This is not an exhaustive list.
• Reviewing monthly statements
• Collection Calls
• Assisting residents/responsible parties with understanding their statements

Working Conditions:

• Nursing home setting.

• Lifting up to 25lbs. when needed.

• Bends, lifts, carries, pushes and pulls various equipment or residents occasionally throughout the work day. Extended, unusual or mandated working hours when required.

Qualifications:

Ability to comprehend instructions, organize time and complete tasks with minimal supervision. Ability to adapt to frequent changes in routine. Competent with personal computers, spreadsheet software, standard office equipment (fax, copier, postage machine, etc.), multi-line phone system, etc. Knowledge of accounting/bookkeeping practices to process charges, generate medical bills and accounts for payment accurately.

Experience: Three years or more of related experience.

Education: High school graduate or equivalent. College level courses desirable. Certification preferred and/or desire to obtain certification/associates.

Physical Requirements: Must be able to lift up to 25 lb. when needed. Bends, lifts, carries, pushes and pulls various equipment or residents throughout the work day. This position requires the ability to perform the essential functions described. These functions are not limited to the following requirements. Reasonable accommodations will be made to otherwise qualified applicants unable to fulfill one or more of these requirements.

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