SNF Managed Med-Cal Billler

Rockport Healthcare Services; Eureka (CA); On-site; USD 55,000 - 75,000; Full time

Job summary

Rockport Healthcare Services seeks an experienced billing professional to manage Medi-Cal claims for skilled nursing facility services. The role requires meticulous review, timely submissions, and diligent follow-up with insurers and government agencies to maintain steady cash flow.

Responsibilities include coordinating authorization, validating supporting documents, and monthly aging reviews to identify and follow up on unpaid accounts.

Qualifications

• 5 Years Managed Medi-Cal Billing Experience in a SNF environment

Responsibilities

• Submits reimbursement claims to third parties (insurance health plans, government agencies, etc.) for services rendered at assigned facilities.
• Ensures claims have the required information in the specified format. Reviews claims for errors prior to submission.
• Submits claims within the required timeframes to ensure consistent cash flow and reduce risk of technical denials for untimely filing.
• Follows up on claims to ensure third party or government agency received the claim.
• Coordinates receipt of insurance authorization with facility and maintains missing authorization log no less than weekly.
• Validates supporting documentation prior to submitting the claim including but not limited to balanced census, triple check, authorization, etc.
• Reviews aging no less than monthly and identifies unpaid accounts. Completes follow-up on all unpaid accounts monthly.

Job description

Essential Job Functions:

1. Submits reimbursement claims to third parties (insurance health plans, government agencies, etc.) for services rendered at assigned facilities.


2. Ensures claims have the required information in the specified format. Reviews claims for errors prior to submission.


3. Submits claims within the required timeframes to ensure consistent cash flow and reduce risk of technical denials for untimely filing.


4. Follows up on claims to ensure third party or government agency received the claim:
   
   
   
   • Electronic billing verification no less than 48-hours after claim submission
   
   
   • Hard copy billing no less than 14 days after claim mailed
   
   
   
   


5. Coordinates receipt of insurance authorization with facility and maintains missing authorization log no less than weekly.


6. Validates supporting documentation prior to submitting the claim including but not limited to balanced census, triple check, authorization, etc.


7. Reviews aging no less than monthly and identifies unpaid accounts. Completes follow-up on all unpaid accounts monthly.

Qualifications:

5 Years Managed Medi-Cal Billing Experience in a SNF environment