Director of Resident Benefits and Payments

2 weeks ago


Milwaukee, United States North Shore Health Care, LLC Full time

**#LI-AS1**:
HYBRID POSITION-WORK FROM HOME AND TRAVEL OCCASIONALLY TO THE OFFICE AS NEEDED
Trust, engagement, competence, respect and passion - these are the values under which North Shore Healthcare operates every day. Our dedicated team of professionals strive to deliver quality care to our residents and their families. We are one of the leading employers and providers of post-acute care in the Midwest and we are seeking exceptional individuals to join our team. If you value being a leader, working in a progressive environment and having opportunities to grow in your career, North Shore Healthcare is the Right Choice for you.

**Summary/Objective**:
Responsible and accountable for the successful management of Private collections and Medicaid eligibility results for assigned areas of responsibility. Supports an environment that promotes a high level of customer service to families, residents, and facility personnel by communicating timely to residents and families regarding benefits and payment expectations.

**Essential Functions**:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Reviews Admission Financial Documents for a viable payer source. Communicates with the facility on missing or incomplete financial documents.
- Reviews Financial System Payer Tree set up for all new admissions and communicates with facility on corrections needed.
- Communicates with the resident/responsible party benefits available and payment responsibility as well as enrollment in RFMS Direct Deposit/Direct Debit.
- Communicates determination of eligibility (approval or denial) to CBO biller, facility ED/BOM.
- Follows the Collections Policy when initiating collection of unpaid Private receivables.
- Communicates progress and continuing collection obstacles to Senior Director, Executive Directors, and Vice Presidents of Success, verbally and /or in writing.
- Communicate/partner with VPS, Sr. Director and ED as needed on all high-risk accounts to identify action needed.
- Communicates with Legal Intake for accounts needing placement.
- Responsible for the Month End Close Process for assigned areas of responsibility.
- Provides continual guidance and assists with performance improvement plans as needed to strengthen skills and correct performance weaknesses of Business Office Managers.
- Assist with training of Business Office personnel on processes, procedures, and systems.
- Assist with the selection of new Business Office Managers.

Safety
- Knows and follows North Shore rules, regulations, and policies
- Follows North Shore dress and hygiene policies
- Demonstrates proper use of equipment. Reports equipment needs or repairs
- Follows North Shore smoking policies
- Reports and documents any incidents or accidents of residents, staff, or visitors to the appropriate North Shore personnel
- Reports all hazardous conditions/equipment to Supervisor
- Uses required protective equipment (as needed during facility visits)
- Follows infection control standards, policies, and procedures

Resident Rights
- Knows Resident Rights
- Maintains confidentiality of resident/patient and employee information Helps the residents/patients exercise and/or protect their rights

HIPPA
- Uses and/or discloses only minimum amount of Protected Health Information necessary to complete assigned tasks
- Follows and adheres to North Shore Healthcare's policies and procedures implementing

HIPPA requirements for the privacy and security of protected health information.
- Reports all suspected violation of company's HIPAA policies or procedures to Center Privacy Designee

Work Environment/Physical Requirements

The responsibilities of this position may involve travel, physical activities including standing, lifting (up to 50 pounds unassisted), bending, stooping, pushing, pulling, and twisting. All employees of nursing homes may be required to provide lifting and transfer assistance to residents. Lifting and/or transferring some residents will require use of a lifting device and /or assistance of other staff.

Required Education and Experience
- Bachelor’s degree in accounting, healthcare administration or business management, or equivalent professional level knowledge and work experience in a related field.
- Minimum of three years ’ experience in healthcare billing, collections and I or accounts receivable.
- Minimum of two years ’ experience supervisory and I or management experience.
- Fundamental understanding of automated billing systems.
- High level of professionalism and leadership ability.
- Strong interpersonal skills, ability to encourage open communications, foster cohesive working relationships and cultivate a team-oriented office environment.
- Ability to audit patient accounts, assess accuracy and collectability of account balances and initiate appropriate collection actions.
- Strong organizational skills, including the ability to prioritize and manage multiple tasks.



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