The successful candidate will be responsible for completing all aspects of billing and reimbursement for Medicaid, Medicare, Managed Care, Private Pay and Patient Liability due monthly for our Park Pointe Skilled Nursing Campus in Morris, Illinois. A particular emphasis will be on billing and collections to ensure that all claims are processed timely and ensuring that revenue from all payor sources is collected monthly. Prior experience with Medicare, Medicaid and MCO billing, especially in Illinois, is highly preferred. Candidates who are dependable, self-sufficient and can readily multi-task are sought.

Responsibilities and Duties

Performs duties and responsibilities as assigned within a nursing home facility which may include, but are not limited to, any combination of the following tasks:

• Verifies benefits for Skilled Nursing Residents, using different means of eligibility verification including telephone, direct access via internet, My Ability, MEDI, and Connex.
• Address and respond to billing inquiries or complaints from clients.
• Perform follow-up on all open and unpaid private pay and surplus balances as requested.
• Applies payments from all payers.
• Prepares and submits claims for all Medicaid and Managed Care.
• Follow all Guidelines and Regulations as set forth by Medicaid, CMS and MCO
• Researching all denied electronic and paper claims. Correct and resubmit as appropriate.
• Communicates with internal and external staff on an as needed basis.
• Handles Insurance inquiries from Resident and Insurance companies in according with HIPAA.
• Submits Admit Pack via MEDI
• Follow ups on Medicaid Pending Cases within the ABE website.
• Enters Discharges and Income changes in the MEDI.
• Submits Medicaid Application via the ABE website.
• Guide the Financial Responsible party through the IDHS Medicaid Redetermination process.
• Enter all payor status changes in PCC and on paper daily census.
• Medicaid Appeal and Audits
• Prepare and edit Medicare Part A & B claims for accuracy before transmission by third party.
• Meet with family member (S) to discuss patient finances and assets to determine if within Medicaid requirements. Guide family members as to what needs to be done to qualify.
• Monthly Hospice billing for Medicaid patients.
• Enter pharmacy, lab and radiology charges monthly.
• Prepare monthly bed tax and submit to HFS.
• Prepare quarterly Medicare Credit Balance report and submit.
• Generate Private and Liability statements monthly.
• Review of aging weekly and follow up on outstanding balances.
• Bill all Medicaid, Medicare, and Managed Care claims on the 1st of each month.
• Long Term Care insurance billing.
• Medicare Billing Certifications.
• Medicare triple check with Therapy department every 1st. of the month.

Qualifications and Skills

• Experience with Illinois Medicaid billing and collections REQUIRED.
• Illinois Medicaid MEDI system
• Experience with SNF/LTC required.
• Understanding of Microsoft Office
• Ability to multi-task in a busy environment.
• Strong communication skills.
• Proficient in Point Click Care proficient.
• Experience with Connex system and various billing portals.

Job Type: Full-time

Job Type: Full-time

Benefits:

• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• Channahon, IL: Reliably commute or planning to relocate before starting work (Preferred)

Work Location: One location

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