Medicaid Billing Specialist

Assist the Business Office Manager in the overall functioning of the Business Office.

Essential Job Functions

This facility expects their employees to promote an atmosphere of teamwork with other employees and hospitality and comfort for its residents. Therefore, the following list of duties is not all-inclusive:

• May perform or assist with the performance of payroll input and hours calculation, answer telephones, ancillary input, receipt of resident account deposits and payments, and processes of accounts payable.
• Strong knowledge with coding: ICD-9, HCPC’s, CMS-1500 and UB-04 forms used in billing.
• Work with or support Business Office Manager and consultants in planning all aspects of Business Office functions to include interface with all other disciplines and departments.
• Will support the Business Office Manager in collections of outstanding balances billed and due which includes AHCCCS, Medicare, commercial Insurance and Private Party Payment.
• Fill in as Business Office Manager as needed with limited or full authority as needed.
• Support and assist Business Office Manager with State, Federal and Company standards, to include alerting management to potential non-compliance issues and the preparation of correction plans.
• Make bank deposits as requested.
• Receive and receipt private, resident portions and Medicaid payments on residents’ bills.
• Assist with end of month packet procedures such as: charge journals, cash receipts including RAs, bank reconciliation, preparation of Resident Trust Fund Accounts for closing and allocation of interest to the proper accounts.
• Assist Office Manager in maintaining a clean, safe, and sanitary work environment.
• Maintain accuracy and efficiency in all work performed.
• Prepare disbursement checks for payment of expenditures approved by Administrator, maintaining and updating daily, the facility’s check register.

Other Duties

• Attend in-service education programs in order to meet facility educational requirements.
• Be familiar with Standard Precautions, Exposure Control Plan, Fire Drill and Evacuation Procedures and know how to use the information.
• Maintain confidentiality of resident and facility records/information.
• Protect residents from neglect, mistreatment, and abuse.
• Protect the personal property of the residents of the facility.
• Others as directed by the supervisor or administrator.

Minimum Qualifications

• Organized and detailed in work performance.
• Must have experience in AHCCCS cliam submission including AHCCCS contracted health plans.
• Must have experience in Medicare and Medicare Advantage Health Plan billing.
• Must have computer skills to enter and track the status of cliam adjudication
• Medical terminology skills preferred.
• Good communication skills with excellent self-discipline and patience.
• Genuine caring for and interest in elderly and disabled people in a nursing facility.
• Comply with the Residents’ Rights and Facility Policies and Procedures.
• Perform work tasks within the physical demand requirements as outlined below.
• Perform Essential Duties as outlined above.