Medical Biller

Park View Health Center- Winnebago County; Oshkosh (WI); On-site; USD 36,000 - 56,000; Full time

Job summary

Park View Health Center- Winnebago County is seeking a billing specialist to handle nursing home billing and related receivables. You will answer residents’ and families’ questions about Medicaid and insurance, and coordinate with insurers to obtain authorizations and payments.

The role requires an associate degree in accounting or equivalent and at least two years of medical billing experience. Proficiency with nursing home software and MS Office is preferred.

Qualifications

• Two years of medical billing experience preferred.
• Knowledge of Medicare/Medicaid billing and insurances.
• Proficient in accurate patient/resident billing records.

Responsibilities

• Calculates charges and reconciles payments for third-party billing, including outpatient; submits claims and copayments by electronic or paper methods.
• Maintains billing logs for cost reports and billing purposes.
• Prepares daily receipts for care and miscellaneous revenues; deposits and enters payments into software.
• Communicates with insurance firms regarding benefits, authorizations, and payments for inpatient and outpatient services.
• Prepares monthly bank reconciliations for Resident Trust Accounts and assists with payroll backup.
• Participates in weekly Medicare meetings and supports other related duties as assigned.

Skills

Medical billing

Accounts receivable

Insurance coordination

Communication skills

Prioritization

Education

Associate degree in accounting

Tools

Medical billing software

Nursing home software

Microsoft Office

Job description

Processes nursing home billing, other receivables, and miscellaneous income.Answers residents’ and families’ financial, Medicaid and insurance questions.

ESSENTIAL FUNCTIONS:

• Calculates charges and reconciles payments for third party billing, including outpatient; submits claims and copayments due by electronic and paper methods.Maintains accurate billing logs for cost reports and billing purposes.
• Prepares daily receipts for care and miscellaneous revenues.Makes deposits through County Treasurer.Enters payments into financial software.Retrieves electronic remittance through Medicare, Medicaid, and insurance company portals and receives paper checks and remits by mail.Posts accounts receivable and prepares worksheets for cost reporting.
• Communicates with insurance firms regarding benefits , andauthorization and payment for inpatient admissions and outpatient clients, and relays information to appropriate facility employees.

ADDITIONAL ESSENTIAL DUTIES:

• Monitors Medicare appeals and alternative dispute resolutions.
• Prepares monthly billing no-pay claims for Medicare and Medicare Advantage and Medicare benefit-exhausted claims according to Medicare guidelines.
• Maintains contact with residents and families regarding Medicare, Medicare Advantage, and private health insurance coverage and billing questions.Contacts insurance companies to verify insurance coverage, and obtains authorizations when necessary.
• Serves as backup payroll processing and for reconciling two cash boxes daily and weekly weekend cash box at reception area.
• Prepares monthly bank account reconciliations for Resident Trust Accounts and prepares reimbursement forms for Finance Department.
• Participates in weekly Medicare meetings.
• Assists with counter transactions when needed.
• Performs other related duties as may be assigned.

WORK RELATIONSHIPS:

• Reports to Financial Services Manager.
• Works with all disciplines within the facility, local hospitals, insurance companies, and residents’ families.

REQUIRED EDUCATION, EXPERIENCE, TRAINING, AND CERTIFICATION:

• Associate’s degree or higher from an accredited institution of higher learning, preferably in accounting or a related field.
• A minimum of two years’ work experience in medical billing.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Knowledge of computerized medical records and nursing home software.
• Ability to prioritize duties and to organize work efficiently.
• Ability to establish and maintain positive working relationships with employees,
• departments and the public.
• Ability to work under minimal supervision and demonstrate independent judgment andcritical thinking skills.
• Strong written and verbal communication skills including listening skills.
• Computer skills including Microsoft Office applications and ability to learn and use nursing home and County software.

PHYSICAL REQUIREMENTS:

• Ability to perform most work from a sedentary position.
• Ability to function in situations encountered in a normal office setting.
• Ability to use standard office equipment including telephone, computer, printer, photocopier, and scanner.