Accounts Receivable Coordinator

Ohio Living; Lincoln (NE); On-site; USD 42,000 - 66,000; Full time

Job summary

Ohio Living is seeking an Accounts Receivable Coordinator - Third Party Billing to manage billing and collection activities for Medicare, Medicaid, and other payer sources across our communities. The role emphasizes accuracy, regulatory compliance, and timely submission of claims.

Responsibilities include reviewing census data, handling preauthorization coordination, and maintaining detailed documentation to support claims and reimbursements.

Qualifications

• Education as stated: high school diploma minimum; associate degree preferred.
• Three years’ billing experience in healthcare preferred; familiarity with AR analytics helpful.
• Must read/write/speak English; proficiency with Windows and MS Office required.

Responsibilities

• Maintain knowledge of billing requirements for Medicare, Medicaid and other third-party funding sources.
• Prepare and transmit all third-party claims electronically by due dates using specified portals.
• Balance and review ancillary service files for monthly close; ensure documents are scanned in EMR.
• Monitor accounts receivable aging and research/resolve balances; correct denied claims daily.
• Assist site personnel with payer education, negotiations, and grievance/appeal processes.
• Support site and corporate teams with reports and process improvements.

Skills

Accounts receivable analytics

English language proficiency

Education

High school diploma or equivalent

Associate degree in related field preferred

Tools

Windows

Microsoft Office (Word, Excel, PowerPoint)

Job description

It's fun to work in a company where people truly BELIEVE in what they're doing! Our intention is to have employees who are passionate about making their personal mission statement come to life each day at work! Be it through providing healing, eradicating loneliness, contributing to efficiencies, streamlining processes, being dependable, sparking creativity or something else, the demonstration of HOW you do your job is just as important as WHAT you do in your job. Alongside our valued employees, we are making a difference throughout the state of Ohio in the lives of those that need healthcare or those embracing the next chapter of their lives. Sustained members of our team demonstrate accountable behavior and share our values of customer service, innovation, inclusion, integrity, financial stewardship, leadership and care.

The Accounts Receivable Coordinator - Third Party Billing, is responsible for all aspects of billing and collection of funds for services provided for patients by our Communities that are funded by Medicare, Medicaid, managed Medicare, managed Medicaid, and all other commercial insurance coverage in accordance with company standards and federal, state, and local standards, guidelines, and regulations.

Essential Activities and Tasks

Billing and Collections

Maintain, obtain, retain and apply knowledge regarding the specific billing requirements for Medicare, Medicaid and all other third-party commercial insurance funding sources. Prepare and transmit all third party claims electronically using specified software and carrier portals within established monthly billing performance timeframe and by prescribed due dates. This includes billing primary and secondary third party agencies. Complete all third party triple check forms for every primary claim prior to release of claims on billing due date. This includes compliance related items, eligibility, coordination of benefits, and census accuracy. Review and balance all assigned ancillary service files provided by various vendors by the prescribed dates for the month end close billing cycle to ensure all ancillary services are captured in billing files to enable accurate claims. Ensure that all required documents are scanned into the electronic medical record for the date required prior to claims release. Adhere to supervisory internal control review requirements before release of claims. Check resident census admissions and information changes daily to ensure that proper third party payer was selected by site representatives, as indicated by the facility insurance payer guide, and make corrections when necessary. Communicate with sites when required precertification, preauthorization, authorization and re-authorizations were not been obtained in order to for appropriate action to occur to minimize uncollectible accounts receivable. Identify and elevate site or payer related issues to supervisor/manager in a timely manner. Monitor status of collections and appropriate cash receipt application to correct patient account balances. Identify denied claims on a daily basis. Research, correct and resubmit claims on a daily basis via prescribed software, third party internet portals, or mail if only option. Escalate any continuing or complicated matters to supervisor/manager for additional attention and potential consultant advisory. Communicate with third party agencies to facilitate successful correction and payment of claims when necessary. Communicate with site representatives when necessary to assist in resolution of denied claims. Assemble information to enable responses to additional development requests to support clinical necessity of claims, and for cases where grievance or appeal is appropriate. Communicate with site and corporate representatives as necessary to facilitate responses to third party agencies. Track and report status. Review third party accounts receivable aging reports to identify outstanding balances and take appropriated action to research and resolve outstanding balances. Goals for overall days in accounts receivable, targeted outstanding balances needing resolution and expecting timing will be established on a monthly basis by supervisor/manager.

Financial Management and Support

Prepare and provide for review and approval all accounts receivable write-off and other types of revenue or receivable balance adjustments as needed with all required supporting documentation. Identify and notify supervisor/manager of other potential issues through use of various reports that may indicate the need to make revenue, receivable, payer, or rate corrections to ensure that revenue and receivables are recorded accurately and timely. Identify and offer suggestions pertaining to process improvements. Communicate collaboratively with the account receivable coordinators - private pay to resolve any common patient/resident receivable matters. Successfully transition through payer education requirements by pre-determined deadlines, including all payer facility contracting relationships, payer rules and regulations and payer appeals and grievances process. Participate in recurring team meetings and trainings. Assist and/or be present for site personnel trainings. Prepares other special reports and performs other tasks or projects as requested and/or required. All other duties as assigned.

Qualifications

• Education High school diploma or equivalent required. Associate degree in a related field preferred, accounting coursework or concentration desired.
• Experience Three years experience performing billing operations preferred. Experience in long-term care, hospital, or other related healthcare accounting preferred. Experience with accounts receivables analytics preferred. Proficiency with Windows, Microsoft Office (Word, Excel, PowerPoint), and the internet required.
• Other Requirements Must be able to read, write, speak, and understand the English language.

Working Conditions and Special Requirements

• Sitting - Up to 8 hours/day
• Standing - Up to 2 hours/day
• Walking - Up to 2 hours/day
• Lifting, transferring, pushing or pulling equipment/supplies - Up to 25 pounds
• Driving - Up to 6 hours/day
• Work weekends, evenings, and holidays - As needed for coverage
• Risk Category for Exposure to Bloodborne Diseases - III

Across our 11 life plan communities, we offer a range of options from independent living apartments and villas to specialized memory care and everything in between. Whether it's a helping hand or skilled nursing care, we're here to provide support at every stage of life's journey. But our commitment doesn't stop at our doorstep. Between Ohio Living Home Health & Hospice and Ohio Living Palliative Medicine, we extend our care to over 10 million Ohioans in the 43 counties we serve. We also offer provider-owned physician and nurse practitioner services, a Medicare Advantage plan, and pharmacy services - because health and wellness go hand in hand. The Ohio Living Foundation raises millions of dollars each year to support the people and programs of Ohio Living. From charity care to special programs and beyond, they’re dedicated to making a difference in the lives of those we serve and ensuring that no one is left behind. At Ohio Living, our mission is that heart of all we do. For over 100 years, it has been our promise to care, to support, and to enrich the lives of our residents and communities.