Salary commensurate with skills, knowledge and experience.
Willing to relocate to Los Angeles.
The essential functions below are not intended to be an exhaustive list of all duties that may be assigned to this position, nor does it restrict the duties which may be assigned to this position if such duties reasonably relate to the position. Salary commensurate with skills, knowledge, and experience.
POSITION:
Under the direction of the SVP Revenue Management, the Medical Biller responsibility and accountability necessary to carry out assigned duties. The primary result of this position is accurately billing and timely collecting of all funds while meeting facility goals, and maintaining highest ethical standards.
REPORTING:
This position reports to the SVP
FLSA STATUS:Non-Exempt
QUALIFICATIONS /REQUIREMENTS:
Education: High School graduate or equivalent
Work Experience:
Background in billing in a Skilled Nursing Facility (SNF), knowledge of Medi-CAL, HMO billing processes. Accurate keyboarding, calculating and computer ability is necessary.
Language Skills:
- Must be able to read, analyze, and interpret common scientific and technical information, and to be easily understood through verbal communication in the English language.
Mathematical Skills:
- Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Ability to perform these operations using units of weight measurement, and volume.
Communication Skills:
- Must have exceptional communication and customer service skills, and be empathetic.
- Ability to effectively communicate outside resources and agencies.
ESSENTIAL JOB FUNCTIONS:
- Submit claims accurately and timely, according to each payer type for which responsible
- Confirm that each billing has been received. Confirmation method varies with payer type, but may include confirming on-line or calling.
- Consult with BOM/BOA regarding daily census management, auth’s determine and verify patient status period, patient file maintenance and statements all items in the business office that contribute to 100% collections efforts.
- Ensure verification of patient payment status, Medi-CAL certs, CWF, auth’s, contracts etc.
- Monitors TAR file, monthly reauthorization TARs to facility; maintain unbilled list; record receipt of Medi-CAL certs. Monitor for receipt of timely approvals and eligibility.
- Facility AR Billing and Follow ups (Weekly MCAL, Bi -monthly CCI, Monthly MRA/HMO)
- Review Benefits and eligibility
- Census Management: Cross Check UB04 Authorizations, payer portal, Tracking logs
- Cash Management: Posting of Cash, Reconciling Cash, updating Cash Log; (EFTs MRA, CCI, HMO Payers)
- Facility Billing (Review Batch, Send claims-mail or electronic)
- Billing using Office Ally and other forms of billing
- Facilitating Adjustment/Correcting of claims
- AR Management; Review of Aging; , MCAL, Managed MCAL, HMO, Co-insurance
- Refunds/Write-Off Management
- Acquisitions/Special Projects
- Handle completion of required procedures for end of month closing
JOB FUNCTIONS:
- Demonstrate knowledge of, and respect for, the rights, dignity and individuality of each resident in all interactions
- Appreciates the importance of maintaining confidentiality of resident and facility information
- Demonstrate honesty and integrity at all times in billing and in care and use of resident and facility property Strict adherence to the Corporate Compliance Program and Standard of Conduct
- Able to understand and to follow written and/or verbal directions. Able to express self adequately in oral and/or written communication. Able to communicate effectively with staff members, vendors and agencies. Demonstrates ability to prioritize tasks/responsibilities and complete duties/projects within allotted time
- Ability to follow through and complete tasks with minimum supervision
Encourage teamwork through cooperative interactions with co-workers and departments. Support a positive and professional image through actions and attire
Able to respond to change productively and to handle additional tasks/projects as assigned
- Able to carry out the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of self and others
Other duties as assigned
PHYSICAL CAPACIITIES:
- Must be able to move intermittently throughout the workday.
- Must be able to see and hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of this position can be fully met.
- Must meet the general health requirements set forth by the policies of this Office which includes an annual TB screening and physical examination.
- Must be able to stand and walk.
- Must be able to sit for extended periods of time.
- Must be able to cope with the mental and emotional stress of the position.
ENVIRONMENT AL CONDITIONS:
Inside work, normal temperatures, some noise, occasional fumes/odors, chemical exposure and potential exposure to blood borne pathogens.
Personnel at every level must follow HIPAA rules and regulations. This position is a Mandated Reporter regarding the suspicion of elder abuse and may have access to Protected Health Information (PHI).
AAP/EEO Statement: Our Company provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Job Type: Full-time
Pay: $30.00 - $35.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
Schedule:
- 8 hour shift
Ability to commute/relocate:
- Los Angeles, CA 90016: Reliably commute or planning to relocate before starting work (Preferred)
Experience:
- ICD-10: 1 year (Preferred)
Work Location: In person
Job Type: Full-time
Pay: $30.00 - $35.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
Schedule:
- 8 hour shift
- Monday to Friday
Ability to commute/relocate:
- Los Angeles, CA 90016: Reliably commute or planning to relocate before starting work (Required)
Experience:
- ICD-10: 1 year (Required)
Work Location: In person
