Business Office Coordinator/Medicaid Coordinator
1100 W Long Ave
DuBois, PA 15801
814 371 3180
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Description
Organize, evaluate, and monitor business office operations.Partner with Admissions to ensure agreements are executed. Ability to follow professional standards, policies and procedures, federal, state, and local requirements, and DOH standards. Maintain HIPPA privacy, security, and confidentiality standards. Complete all Health Center billing, including HMO and Medicare. Meets with the team to review treatment plans and changes in financial status. Monitor amended contracts and ensures proper billing rates. Verification of Medicare days used. Participate in the monthly triple-check process for Medicare Part A & B claims. Participate in quarterly compliance meetings and ensure Health Center billings meet all Federal and State guidelines. Reconciles the census at month end & notifies appropriate ancillary service providers that bill based on census levels. Maintain separate files for Medicare remittances, hospice payments, Medicare denial letters, and monthly trainings for changes.
Tasks
- Input appropriate billing code.
- Ensures accuracy of patient insurance before and throughout admission.
- Responsibilities include confirming prior authorization, stop/hold, accounts receivable, payment posting.
- Data entry of all patient demographics, guarantor, and insurance information, posting procedures, and insurance/patient payments.
- Determines appropriate coding and Medicare and insurance pricing.
- Insurance verifications, confirmation of sales orders, obtain prior authorization, claims adjustment, and follow up with outstanding accounts receivables
- Ensures Medicare/Medicaid/Insurance claims are processed timely and correctly
Qualifications / Education
- Business Office Coordinator experience in a Skilled Nursing Facility or healthcare field is REQUIRED.
- Proficiency in Microsoft Word and Excel.
- Ability to learn multiple Account Receivables Software.
- Able to interact professionally with residents, families, staff and other business providers.
