Medicare/Medicaid Billing Manager

4 weeks ago

Wauwatosa, United States MRA Recruiting Services Full time
Job Title: Revenue Cycle Manager
Company: St. Camillus
Location: Wauwatosa, WIJob Standards
  1. Minimum five years of experience in a business office environment, preferably in a post-acute healthcare environment.
  2. Hands-on experience with a computerized billing system.
  3. Ability to interact tactfully with residents and/or their financial responsible parties.
  4. Leadership experience and strong communication skills
  5. Accuracy in recording changes/credits to the residents account.
  6. Ability to solve problems and make sound judgments/decisions based on facts available. Use initiative appropriately.
  7. Ability to maintain and safeguard entrusted confidential information.
  8. Ability to safely perform the entire essential job functions without causing harm to self or others with or without reasonable accommodation.
Essential Job Functions
  1. Adheres to the philosophies, policies and procedures of St. Camillus Campus.
  2. Understands and supports the Resident/Client Bill of Rights.
  3. Adheres to all policies and procedures regarding resident/client and staff safety.
  4. Understands and agrees to comply with the obligations contained in the St. Camillus Code of Conduct.
  5. Understands and supports the St. Camillus Employee Job Behaviors.
  6. Ensures the confidentiality of resident/client or staff records is maintained in accordance with HIPPA requirements.
  7. Ensures work is completed thoroughly and accurately, to minimize errors and rework.
  8. Complies with all required training and participates in all mandatory meetings.
  9. Supervise and train a team of billing/revenue cycle staff. This includes mid-year and annual evaluations.
  10. Audits monthly Accounts Receivable agings and meets with billers to monitor and analyze collectability. Makes recommendations to VP-Finance regarding account balances to write-off.
  11. Prepares and updates all A/R and census related schedules on a monthly basis and for fiscal year end audit.
  12. Assist VP-Finance and CFO in analyzing and determining impact of changes in payment methodology. Ensure electronic billing system is updated and is in compliance and accurately reflects current reimbursement programs.
  13. Evaluate current contracts related to reimbursement including Therapy, all Medicaid long-term care, Medicare Advantage and other insurance to ensure terms are beneficial and current services provided align with contract terms and provide appropriate reimbursement to St. Camillus.
  14. Evaluate the need for other payer contracts and assist with contract establishment and negotiation of terms if St. Camillus enters into contract.
  15. Ensures that billing policies and procedures are documented, followed and that proper backup exists. Recommends and implements additional efficiency and controls where appropriate.
  16. Responsible for accurate and timely imputing of all charges/credits into a computerized billing system for Health Center and Assisted Living residents.
  17. Responsible for coordinating and running the month-end statements for Health Center and Assisted Living residents, reviewing them for accuracy, stuffing and mailing the statements.
  18. Review all resident changes (adds, deletes, changes) and record appropriately and on a timely basis in the charge system.
  19. Enter or import charges for Physical Therapy, Occupational Therapy, Speech Therapy, Barber/Beauty Shop, equipment rentals, oxygen services, and laboratory tests for Health Center residents into the computerized billing system.
  20. Responsible for electronic billing for Medicare Part A & B and Medicaid and for keeping up with changes in governmental programs and regulations impacting billing.
  21. Billing of benefit exhaust and No Pay claims as needed per Medicare and Managed Care guidelines.
  22. Billing of Community Care claims and viewing authorizations through the online portal.
  23. Responsible for aging follow-up and collections, including correcting and resubmitting Medicare, private insurance and Medicaid rejections timely.
  24. An understanding of UB-04 forms and the requirements for billing services rendered.
  25. Responsible for communicating with other departments to expedite the flow of charge data for input into the billing system.
  26. Maintain a master file of all pertinent documents (contracts, billing information) for Health Center and Assisted Living residents.
  27. Responsible for maintaining accurate nursing home census.
  28. Maintains computerized resident funds accounts.
  29. Implements other duties and manages projects as assigned by supervisor.


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