Project Analyst - Long Term Care

Atrium Health; Charlotte (NC); Remote; USD 60,000 - 75,000; Full time

Job summary

A leading healthcare provider in Charlotte is seeking an expert in reimbursement and compliance for Medicare and Medicaid. The role involves training staff on billing practices, resolving complex patient account issues, and ensuring regulatory compliance across long-term care facilities.

Qualifications

• 2 years experience in LTC reimbursement or 4 years in LTC industry.
• Knowledge of LTC reimbursement and regulations.

Responsibilities

• Researches Medicare and Medicaid billing regulations.
• Evaluates billing practices and recommends changes.
• Handles complex collection issues.

Skills

Reimbursement

Compliance

Billing Regulations

Education

Bachelor's Degree

Job description

Charlotte, NC, United States
Job ID: 123358
Job Family: Financial Services
Status: Full Time
Shift: Day
Detailed Shift and Schedule: Remote
Job Type: Regular
Department Name: 41011008041251-Billing

Overview

Job Summary

Serves as the expert in reimbursement and compliance issues relating to Medicare, Medicaid and other third party payers in long term care. Conducts in-service training regarding changes in regulations and billing practices. Resolves difficult and non-routine issues related to patient accounts and serves as a liaison in dealing with legal remedies for collection of problem accounts. Evaluates billing practices at all Long Term Care (LTC) facilities recommends changes in patient accounting and other reimbursement procedures as needed.

Essential Functions

• Researches Medicare and Medicaid billing regulations, coordinates communication of changes, and provides training to appropriate individuals. Knows what supplies and services are reimbursable in LTC and under which programs.
• Evaluates impact and regulations of new services and related charge and billing issues.
• Manages reimbursement, rate and charge structure changes in billing system, sets up or revises procedures codes and related information, extracts reports and other info as needed from the billing system.
• Serves as a resource to billing department through assistance with difficult issues and assists with transitioning of new billing taken on from additional facilities within the system.
• Evaluates billing practices of LTC facilities and recommends changes as needed to ensure regulatory compliance and maximum reimbursement.
• Handles limited accounts which involve substantial exception or complex collection issues. Works with the legal department and other necessary resources to develop collection strategies for LTC and resolve problem accounts.

Physical Requirements
Work requires access to and organization of records occasionally. Must be able to lift up to 30 pound boxes. Some travel required. Performs other appropriate duties as assigned by supervisor. Each employee has a responsibility to work in a safe manner.

Education, Experience and Certifications

Bachelor's Degree with 2 years experience in LTC reimbursement or 4 years experience in LTC industry dealing with reimbursement and billing related issues. Must be able to demonstrate knowledge of LTC reimbursement and regulations as it relates to billing Medicare, Medicaid and other third party payers.