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Medical Biller and Accountant
4 months ago
Position Summary
SUMMARY
Under the direction of the Accounting Manager, the Healthcare Billing Accountant (HBA) will oversee the Medicaid portion of the revenue cycle by analyzing and auditing various Medicaid reports. The HBA is also responsible for receiving Medicaid enrollment documentation, generating invoices, processing cash receipts, and monitoring and reconciling accounts receivable at a participant level for all participants. The HBA will ensure that is paid accurately for the participants’ level of Medicaid and that their benefits are coordinated accordingly. The HBA possesses the necessary technical and interpersonal skills to efficiently and effectively support the Finance Department and the goals and objectives of the program.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Under general direction and in accordance with all applicable federal, state and local laws/regulations and policies, procedures and guidelines, this position includes the following:
1. Establishes, organizes, and maintains a system that will provide a functional structure of all participant files received within the Finance Department, using available technology and other supports.
2. Performs audits and reconciliations on various government reports according to finance policies and procedures (ex 820).
3. Conducts Finance orientations for staff.
4. Communicates orally, in writing, and in-person with CMS (Centers for Medicare and Medicaid Services) staff, OLTL (Office of Long-Term Living) staff, CAO (County Assistance Office) staff, staff, participants/families and others regarding outstanding balances, discrepancies and other account issues.
5. Processes all enrollments and disenrollments within the accounting system according to finance policies and procedures.
6. Performs accurate Medicaid, Nursing Facility Patient Pay (NFPP,) and Private Pay invoice and payment processing in the Accounts Receivable sub-ledger of the accounting system on a timely basis, according to finance policies and procedures.
7. Reconciles patient pay and private pay invoices accurately and on a timely basis, according to finance policies and procedures.
8. Generate correspondence (written and oral) to internal staff, participants and/or their families regarding unpaid account balances.
9. Reviews Accounts Receivable balances, researches invoice adjustments, and proposes appropriate write-offs, cash reallocations and required journal entries with supporting documentation.
10. Acts as a backup to the Senior Healthcare Billing Accountant (SHBA) as needed.
11. Assists in preparing documents needed for CMS, financial and other audits as required.
12. Will make suggestions to finance director/accounting manager regarding policy and procedure updates with current finance processes.
13. Actively participates in quality improvement to transform work processes and outcomes in support of the values, policies and all regulatory requirements.
GENERAL RESPONSIBILITIES
1. Knows and adheres to the philosophy and goals of the program.
2. Ensures that services are delivered in a manner adhering to the philosophy, mission, and intent of the Program of All-Inclusive Care for the Elderly.
3. Maintains a quiet and safe environment for participants, visitors, and staff.
4. Keeps records, reports and discussions of enrolled and potential participants confidential.
5. Participates in the formulation and maintenance of policies and procedures.
6. Participates in committees as requested.
7. Maintains flexibility in schedule and responds to unexpected emergencies, changes in workload and vacation coverage in order to fill responsibilities.
8. Utilizes supplies and equipment economically.
9. Identifies service delivery problems and uses good judgment in their resolution.
10. Always maintains a professional appearance and manner.
11. May serve as a role model for students and staff.
12. Pursues professional growth through the continuing education process.
13. Performs other duties as required.
Company DescriptionCross Country Workforce Solutions Group (CCWSG) is a human resource, consulting and talent acquisition firm, specializing in PACE Programs, FQHCs/CHCs, and State Healthcare plans throughout the US. Our national operations center is located in Southern California.
CCWSG provides clinical and non-clinical staffing support to PACE centers across the country; we are the nation’s exclusive provider of non-medical, in-home caregivers for the elderly enrolled in PACE programs. Currently, we have over 3,000 caregivers supporting patients in their homes through PACE.
We are a part of the Cross Country Healthcare family, a market-leading workforce solutions, tech-enabled talent platform, and staffing, recruitment, and advisory firm with almost 40 years of industry experience and insight. We are a full-service partner, combining market expertise and services, including contingent staffing, consulting, human capital, management solutions, recruitment process outsourcing, vendor management, and direct hiring.Company DescriptionCross Country Workforce Solutions Group (CCWSG) is a human resource, consulting and talent acquisition firm, specializing in PACE Programs, FQHCs/CHCs, and State Healthcare plans throughout the US. Our national operations center is located in Southern California.\r
CCWSG provides clinical and non-clinical staffing support to PACE centers across the country; we are the nation’s exclusive provider of non-medical, in-home caregivers for the elderly enrolled in PACE programs. Currently, we have over 3,000 caregivers supporting patients in their homes through PACE.\r
We are a part of the Cross Country Healthcare family, a market-leading workforce solutions, tech-enabled talent platform, and staffing, recruitment, and advisory firm with almost 40 years of industry experience and insight. We are a full-service partner, combining market expertise and services, including contingent staffing, consulting, human capital, management solutions, recruitment process outsourcing, vendor management, and direct hiring.
