Managed Care Billing Specialist

Skokie Support Services Center    Skokie, IL
Job Description

CERTIFIED AS A BEST PLACE TO WORK & due to company growth - We are looking to add an experienced Managed Care Billing Specialist to our team!

We’re Villa, and we make people better. It’s our philosophy and way of life. Our goal is to never settle on behalf of our guests, their families, and our staff – in short, our people. We push the boundaries of our industry standards, by striving to better the lives of all people we come across and by always doing more than what is expected. Everything we do is rooted in making people better by always being better ourselves. Of course, we’re focused on quality care and good outcomes. But we’re here to do so much more. Villa’s leadership has a vision of rising above the status quo—of never settling, and of shattering the old image of this industry. We’ve always wanted to be a part of something greater, and we’re making that a reality. Our commitment to our people, our environment and clinical programs will allow us to fulfill our mission of making people better.

Our employees supplement their clinical expertise with passion and a willingness to exceed expectations, every time. Work can be fun when you feel you’re a part of something bigger, and the members of our Villa family illustrate this daily. As a team, we commit to being BETTER: We are committed to positive employee engagement through team work & recognition, resulting in an increase in positive clinical outcomes through communication and respect.

ESSENTIAL FUNCTIONS:

  • Interface with nursing center Business Office Manager and other center staff in review of billing information.
  • Evaluate accuracy and completeness of information for claim submission.
  • Utilize corporate billing system to process monthly billing including electronic transmission (or paper submission if required) of claims to third party payers under corporate billing policies and procedures.
  • Track authorizations for services when appropriate for third party billing. Interface with nursing center staff to meet all requirements.
  • Monitor claims processing and payment.
  • Monitor recorded payments and adjustments within the billing system.
  • Prepares and submits claims to third party payers, both in paper and electronic format.
  • Performs collections follow-up process in accordance with established procedures.
  • Maintains centralized billing files in an organized and consistent manner. Document process and communications within the billing system on all claims/activities.
  • Participate in month end review and submission of information to finance department in a timely manner.
  • Manages high volume of complex financial data that requires a high volume of accurate data entries and reconciliation.
  • Resource to Regional Business Advisors, Business Office Managers, and others regarding rules and regulations surrounding billing/payment under the various programs of their specialty. Requires extensive knowledge of third party programs.
  • Observe and identify consistency differences in policies, procedures, and practices between companies under a single ownership. Advise Supervisor and Director of Billing for modifications when such will improve on consistent standards, efficiency, and/or reduce inherent risk to the ownership group.
  • Participate in and maintain highest level of training and knowledge on software used for billing.
  • Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; participating in team development.
  • Contributes to team effort by accomplishing related results as needed.
  • Ensures integrity and confidentiality of all patient and client financial data.
  • Adheres to all facility Standards of Practice as well as state and federal guidelines.
  • Asks for assistance when needed.
  • Other duties as assigned by the Billing Supervisor.

Must Have:

  • Previous experience with managed care billing in long term care/skilled nursing center.
  • Great customer service skills
  • PCC and MS Excel

www.villahc.com

EOE

Villa1


Sun, 15 Dec 2019 08:57:04 GMT

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