Account and Benefits Specialist

2 weeks ago

Pawnee County, United States State of Kansas Full time

Employment Benefits

Comprehensive medical, mental, dental, vision, and additional coverage

Sick & Vacation leave

Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave

Paid State Holidays (designated by the Governor annually)

Fitness Centers in select locations

Employee discounts with the

Retirement and deferred compensation programs

Position Summary & Responsibilities

Position Summary:

Establish patient eligibility for Medicaid, billing/collecting all Medicaid revenues and preparation of information for the Medicaid Cost Report

Process all revenues received for inpatient hospitalization into the Fee Fund account

Conduct face-to-face patient interviews to determine ability to pay

Collect delinquent debts owed to Larned State Hospital

Compile spreadsheets for Therapeutic Work Program earnings/obligations

Settlements of uncollectible charges are processed monthly

Maintains balances of Patient Trust Fund Accounts

Other duties critical to the functioning of the Reimbursement Department

Job Responsibilities may include but are not limited to the following:

Establishes Patient Eligibility for Medicaid and sends 2126 for admits and discharges for appropriate level of care determinations. Processes monthly Medicaid billings for services provided to eligible patients Works with Medicaid representatives to resolve level of care and billing issues. Assists, guardians, conservators, relatives and social workers as needed with Medicaid information pertaining to Social Security, obligations, payments, etc. Timely follow-up is necessary in order to ensure Medicaid applications and level of care is updated within required time frames; eligibility must be established before billing for payment can occur Serves as a back-up for Medicaid billing to the PSA II Receives Medicaid RA and claim after payment to Generates Medicaid Logs in Patient Account Management Accounts Receivable ( EHR ) System Tracks all Medicaid hospital charges in a spreadsheet. Determines payments, paid/pending/denied days and charges creating a Medicaid record for the fiscal year. Verifies payment for services against charges billed. Sends monthly Medicaid billable list to Clinical Information Management and LSH Utilization Review Coordinator Prepares annual Medicaid Cost Report by using data from the Medicaid log and submits to LSH Chief Financial Officer and PSAII

Fee Fund Deposit / Patient Payment Duties

Processes all Payments for Inpatient Hospital Charges Prepares Payment Journal for Patient Account Management Accounts Receivable (EHR) System Prepares LSH Fee Fund bank deposit as required Sends completed deposit slip and payment information to LSH Accounting Department and places in the appropriate bank bag to be taken to the bank on a regular basis. Provides deposit information to Accounting Department via spreadsheet through a shared drive for LSH Fee Fund reconciliation

Interviewing Duties

Interviews admissions to the Psychiatric Services Program, State Security Program and the Sexual Predator Treatment Program Identifies third party payment resources and secures signatures to release information in order to obtain payment from third party payers Send notification for any other payors to appropriate staff. Explains billing procedures and how Medicare/Medicaid/Insurance would assist in payment of the patient’s hospital bill Explains payment responsibility to patients and those responsible for payment on inpatient hospital charges Retrieves funds daily from locked money boxes to deposit into the Patient Trust Fund.

Collection/Settlement Duties

Collects unpaid past due accounts according to department policy and procedures Prepares collection letters to patients and/or responsible parties requesting payment for past due accounts for Psychiatric Services Program, State Security Program, the Sexual Predator Treatment Program Answers questions regarding patient’s bill by telephone, mail or in person Determines if a patient account has been paid in full Reviews patient/resident files to determine all collection efforts have been exhausted Refers patient/resident accounts to the PSA II for final disposition

Patient Trust Fund and Patient Accounts

Posts daily transactions to each patient’s Trust Fund account utilizing the current patient account management system Receives patient payroll reports from Vocational Training Program staff on a bi-weekly basis Receives payroll deposit confirmation reports from the banking institution on a bi-weekly basis Prepares Patient Therapeutic Work Program earnings and obligations spreadsheet involving complex equations/formulas on bi-weekly basis Sends Payroll slips to patients/residents Receives LSH 383’s for purchase of Glasses/Medicaid Equipment. Determines it patient/resident has available funds to purchase this item using their funds. Tracks expense and reserves money for the item. Sends request to PTF Custodian to pay the supplier using PTF money if available. Sends a notification to Accounting for payment of LSH funds as needed. If LSH funds pays for the items will track when the patient/resident has adequate funds to repay LSH for the item. Monitors LSH Fee Fund for EFT payments for patient/resident direct deposits. Advised PTF of the source and deposit amount for each patient/resident and any board and care obligation for payment to the LSH Fee Fund.

Miscellaneous Duties

Serves as back-up for entering the Laboratory, Dental and Consultants charges into the Patient Account Management Accounts Receivable System Operates the Patient Trust Fund in the absence of the Patient Trust Fund custodian Assists the Patient Trust Fund Manager with Canteen as needed Other duties as assigned to ensure that the Reimbursement Department provides adequate services to the patient and staff at LSH.

Qualifications

Minimum Qualifications :

One year of experience in providing direction necessary to implement the objectives of an agency, program or organizational unit. Education may be substituted for experience as determined relevant by the agency. Experience in billing patient hospital charges to insurance Experience with balance of patient accounts Experience with payroll and determination of monthly patient obligations

Preferred Qualifications :

Post-Offer, Pre-employment Requirements : Ability to pass a KBI background and pre-employment drug test.

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