Senior Healthcare Revenue Specialist

7 days ago


San Diego, California, United States Casa De Las Campanas Full time
About Casa De Las Campanas

Casa De Las Campanas is a residential care facility that offers upscale resort-style living in the scenic area of Rancho Bernardo. Our team of dedicated professionals strives to improve the lives of seniors in our community on a daily basis.

Benefits
  • $35.00 - $42.00 per hour salary range
  • No employee cost share for medical insurance
  • Dental and Vision Insurance
  • Now offering DailyPay
  • An employee appreciation bonus, which is funded by our residents
  • Life insurance
  • Long-term disability insurance
  • 403 (b) retirement plan with employer match
  • Tuition reimbursement program
  • PTO and paid holidays
  • Pet insurance
  • AFLAC
  • Monthly Employee Engagement Activities
Job DescriptionHealth Center Billing Specialist Role

The Health Center Medical Billing Specialist shall be responsible for all aspects of Health Center Billing, including HMO and Medicare Billing, Accounts Receivable, and A/R Cash Receipts. They shall also provide backup assistance for other accounting staff.

Key Responsibilities:
  • Completes all Health Center billing, including HMO and Medicare is completed
  • Meets daily with the HC Leadership team to review treatment plans and changes in financial status
  • Monitors amended contracts and ensures proper billing rates
  • Verification of Medicare days used
  • Participates in the monthly triple-check process for Medicare Part A & B claims
  • Participate in quarterly compliance meetings and ensure Health Center billings meet all Federal and State guidelines
  • Reconciles the census at month end & notifies appropriate ancillary service providers that bill based on census levels
  • Maintain separate files for Medicare remittances, hospice payments, Medicare denial letters, and monthly training on Noridian for changes
  • Input appropriate billing codes into Vision
  • Ensures accuracy of patient insurance before and throughout admission
Accounts Receivable & Purchasing:
  • Ensures all records used for Accounts Receivable are complete and accurate
  • Maintains contract files on Health Center residents
  • Inputs Accounts Receivable information into the computer database
  • Processes Accounts Receivable data and prepares billing statements, including an audit review, for distribution
  • Prepares monthly Accounts Receivable reports and uses them for account analysis and timely follow-up of aging accounts
  • Maintains McKesson software database relating to healthcare supplies
  • Ensures the charge-capturing system continues to capture data
  • Complete Medicare Credit Balance Report
  • Communicates related accounting data with residents, staff, and others professionally and courteously
  • Follows claims through Medicare audits and appeals to ensure prompt payment and any refunds are issued promptly
  • Verifies that all HMO claims are received promptly via telephone or Internet
  • Assist other departments including purchasing and admissions, MDS, and medical records to ensure a timely billing process
  • Bill Medicare co-insurance when appropriate
  • Verify all ancillary charges for accuracy and reasonableness, including oversight of central supplies billing
  • Complete the check-off list for Medicare ADR (Additional Documentation Requests) in an organized manner


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