BUSINESS OFFICE MANAGEMENT IN A SKILLED NURSING FACILITY IS HIGHLY DESIRABLE. MEDICAID/MEDICARE, MANAGED CARE, PRIVATE PAY COLLECTIONS WORKING WITH FAMILIES AND PCC SOFTWARE EXPERIENCE IS A PLUS.
The primary purpose of the Resident Financial Coordinator position is to evaluate and monitor the financial viability of all referrals to Vanguard facilities, communicate financial and benefit information to residents and/or family members, collect patient liabilities, copays, and other private pay charges upon admission and on an ongoing basis, monitor the application and approval status of all Medicaid Pending residents, administer the resident trust, maintain and report resident demographic, financial, and census data, assist the Centralized Billing Office with charge capture activities for ancillary and other charges.
JOB DUTIES and RESPONSIBILITIES:Resident Financial Functions
Receive, review and evaluate all referrals for potential admission to a Vanguard facility, to determine financial eligibility and viability.
Review the common working file for Medicare-funded referrals to determine Medicare eligibility.
Communicate financial viability to the Admissions Coordinator and discuss medications, equipment and other special needs that impact cost of care.
Prepare a cost projection for all financially viable referrals to Vanguard facilities, based on determination of clinical and other needs (as identified by the Admissions Coordinator).
Determine Medicare Part B coverage prior to the initiation of therapy services by the therapy vendor.
For all referrals who will convert to Medicaid during length of stay, determine whether or not the Medicaid application process has been initiated; Work with the referral source and family to initiate the process if not yet begun. Review the state's home page to determine whether or not the referral currently has property or has recently transferred assets which would prevent Medicaid eligibility. Initiate Medicaid-pending tracking log.
Ensure the timely submission of all required assessments and documentation related to Medicaid eligibility (PAE, PASARR, DMAS, FL-2, etc.). Ensure that these forms are updated and resubmitted as necessary.
Determine the need for and obtain pre-authorization for managed care payers including those for primary, secondary, and ancillary services.
Ensure that required ongoing authorizations are obtained by facility clinical staff.
Collect all upfront monies due upon admission.
Ensure the collection of all private pay balances as they become due and payable.
Ensure that resident admission contracts are signed and appropriately filed.
Ensure appropriate supporting documents are scanned into the electronic medical record (consent to treat, common working file (CWF), copies of insurance cards, etc.)
Verifies and records specific ancillary charge information as directed by the corporate office.
Compiles and submits daily deposits via the remote deposit process.
Ensure that adequate cash management control processes are in place for cash receipts, deposits, petty cash, etc.
Census Management Functions:
Enter complete and accurate financial, demographic, and census data into the electronic medical record (PCC).
Record any census changes (admission, readmission, discharge, bed hold, room change, payer change, liability change, level of care change, etc.).
Reconcile the recorded census to the midnight census each business day by 10 am CST.
Resident Trust Management
Administers the resident trust software (RFMS) according to established policies and procedures.
Completes resident trust enrollment forms with new residents. Encourages participation by all residents and constantly strives to increase enrollment.
Ensures that direct deposit and liability data are updated in RFMS timely and that the information there matches the information in PCC.
Reconciles the resident trust accounts on a monthly basis, resolving any reconciling items within 30 days.
Ensures that the resident trust fund petty cash box is balanced at all times.
Monitors the trust balance to ensure that the established surety bond is adequate to cover the account balance in accordance with state requirements.
Attends the facility daily stand-up meeting to update facility staff and leadership of issues related to resident financial matters, bed control and census, etc.
Attends the weekly utilization management meeting to ensure that information from those meetings is shared with the corporate billing staff.
Serves on various committees of the company to review financial and/or operational policies and procedures and provide written reports as directed by the Administrator, Director of Revenue Cycle, the Chief Financial Officer and/or the Director of Operations.
Staff Development Functions
Assist with in-service training in matters of Medicare, Medicaid, private pay, HMO eligibility and benefits, coding and billing.
Attend and participate in annual OSHA, Corporate Compliance and infection control in-service training programs.
Ensure adequate control/process is in place for the receiving, tracking and shipping of IT equipment.
Safety and Sanitation Functions
Follow established safety regulations, to include fire protection/prevention, smoking regulations, infection control, etc.
Follow established ergonomics policies and procedures governing lifting techniques, repetitive tasks, and the use of safety equipment and supplies to prevent work-related injuries and illnesses.
Resident Rights Responsibilities
Maintain strict confidentiality of all resident information.
Assist in the development and implementation of accounting procedures for safeguarding residents' funds.
Assist, when requested by a facility Administrator, in advising residents on financial matters that will promote their highest well-being (e.g., information on pensions, trusts, Medicare/Medicaid eligibility, etc.)
Works in office areas of the skilled nursing facilities.
May occasionally work in a designated area of a facility.
Moves intermittently during work hours.
Is subject to frequent interruptions.
Is involved with referral sources, home office and facility-based personnel, government agencies/personnel, and occasionally, residents and families, under all conditions and circumstances.
Is subject to hostile and emotionally upset referral sources, residents, family members and personnel.
Works beyond normal working hours and on weekends and holidays when necessary.
Attends and participates in continuing education programs.
Maintains a liaison with the referral sources, home office and facility associates and, occasionally, residents and families, to adequately plan for the residents' needs.
JOB REQUIREMENTS: Education
Must be able to read, write, speak and understand the English language.
Must display professionalism both in appearance and attitude.
Must possess the ability to solve problems and make independent decisions when circumstances warrant such action.
Must genuinely care for and understand the elderly and disabled.
Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agency personnel and the general public.
Must possess the ability and the willingness to work harmoniously with other personnel.
Must be able to plan, organize, develop, implement and interpret the programs, goals, objectives, policies and procedures that are necessary for sound accounting and business techniques.
Must have patience, tact, a positive disposition and enthusiasm, as well as the willingness to handle difficult people.
Must be knowledgeable of accounting principles, laws, regulations and guidelines pertaining to long-term care administration.
Must possess the ability to seek out new methods and principles and be willing to incorporate them into existing business and accounting practices.
Must be knowledgeable and able to show skills within a Microsoft environment(Word, Excel, Outlook and similar software),ability to problem solve and learn new software and processes, including, but not limited to data entry, output, system applications, etc.
Must be knowledgeable of principles of governmental accounting including budgeting, cost reporting, taxation, etc.
Must possess the ability to examine and verify financial documents and reports.
Must not pose a direct threat to the health or safety of other individuals in the workplace.