Medical Billing Specialist

Position Title: Medical Billing Specialist

Schedule: 32 hours per week

Salary: $35.00 - $42.00

Who we are:

Experience the future of senior living and care as soon as you step foot into our doors. Casa de las Campanas offers upscale resort-style living in the scenic area of Rancho Bernardo. Our team of dedicated professionals strives to improve the lives of seniors in our community on a daily basis. Our campus and surroundings reflect the love that our residents have for southern California. Our unique combination of an all-inclusive lifestyle, exceptional hospitality, and stunning location is unmatched. Our well-traveled and outdoorsy senior community enjoys socializing over meals, exploring nearby trails, and taking in breathtaking views. We are currently seeking a talented Medical Billing Specialist for our Health Center. If you want to experience a fresh perspective on senior living, join us today!

You will enjoy:

• Medical Insurance

• Tuition reimbursement program

• An employee appreciation bonus, which is funded by our residents

• Now offering DailyPay!

• 403 (b) retirement plan with employer match

• PTO and paid holidays

• An exceptional work environment that is both engaging and fun!

Who you are:

• High school diploma or equivalent

• Medical Billing Certification

• 1-2 years of Accounts Receivable experience or 3-4 years' experience in Accounts Receivable, with skilled nursing billing experience

Job Summary:

The Health Center Medical Billing Specialist shall be responsible for all aspects of Health Center Billing, including HMO and Medicare Billing, Accounts Receivable, and A/R Cash Receipts. They shall also provide backup assistance for other accounting staff.

Essential Job Duties

Health Center Billing

• Completes all Health Center billing, including HMO and Medicare is completed.

• Meet daily with the HC Leadership team to review treatment plans and changes in financial status.

• Monitors amended contracts and ensures proper billing rates.

• Verification of Medicare days used.

• Participates 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 training on Noridian for changes.

• Input appropriate billing codes into Vision.

• Ensures accuracy of patient insurance before and throughout admission.

Accounts Receivable & Purchasing

• Ensures all records used for Accounts Receivable are complete and accurate.

• Maintains contract files on Health Center residents.

• Inputs Accounts Receivable information into the computer database.

• Processes Accounts Receivable data and prepares billing statements, including an audit review, for distribution.

• Prepares monthly Accounts Receivable reports and uses them for account analysis and timely follow-up of aging accounts.

• Maintains McKesson software database relating to healthcare supplies. Ensures the charge-capturing system continues to capture data.

• Complete Medicare Credit Balance Report.

• Communicates related accounting data with residents, staff, and others professionally and courteously.

• Follows claims through Medicare audits and appeals to ensure prompt payment and any refunds are issued promptly.

• Verifies that all HMO claims are received promptly via telephone or Internet.

• Assist other departments including purchasing and admissions, MDS, and medical records to ensure a timely billing process

• Bill Medicare co-insurance when appropriate.

• Verify all ancillary charges for accuracy and reasonableness, including oversight of central supplies billing.

• Complete the check-off list for Medicare ADR (Additional Documentation Requests) in an organized manner.

All Employees must be able to pass background checks (fitness for duty physical, fingerprinting, employment references) as required by a licensed residential care facility. Some of the roles in our community require that we ask about your COVID-19 vaccination status.

EOE