Medical Biller

Description

* EXCELLENT BENEFITS * AMAZING TEAM * APPLY TODAY *

A Great Place to Work. A Great Place to Receive Care! Our Nursing Home Facility located in Rome, NY is seeking an experienced full-time Resident Finance Coordinator. Betsy Ross Nursing & Rehab Center is a 120-bed facility offering excellence in rehabilitation and skilled nursing care in a lovely homelike environment undergoing AN EXCITING LARGE-SCALE RENOVATION UNDER NEW MANAGEMENT AND ADMINISTRATION! With a focus on rehabilitation and recovery, our skilled team of therapists and healthcare professionals assist residents in achieving optimal health and well-being. Our mission is to provide high quality care to all with respect and compassion through a team approach that focuses on personalized goals. We offer EXCELLENT Aetna Health benefits 1st of the month after hire date, along with other key benefits to those who qualify! 

Medical Biller Job Summary: You play a key role in managing NYS Medicaid applications, insurance verifications, and financial processes to ensure accurate records and timely reimbursements for residents.  This role is responsible for processing claims, verifying patient information, managing collections, and ensuring compliance with billing regulations.

• Verify  census data and maintain financial classes and authorizations for billing accuracy.
• Submit medical claims to insurance companies and government programs (Medicare & Medicaid) accurately and in a timely manner.
• Work  with vendors to obtain ancillary charges and input them into the billing system.
• Review, correct, and resubmit denied or rejected claims to maximize reimbursement.
• Conduct follow-ups on unpaid claims, manage collections, and resolve billing discrepancies.
• Collaborate with healthcare providers to obtain necessary documentation for accurate billing.
• Bill  and collect on private pay accounts and monthly income.
• Post cash receipts for all deposits in a timely manner.
• Verify and update patient admissions, insurance information, and financial data in all relevant systems.
• Participate in internal and external financial audits to ensure compliance.
• Provide information for the yearly RHCF (Residential Health Care Facility) report.
• Attend Utilization Review (UR) meetings weekly and Corporate Compliance meetings monthly.
• Act as a backup to the Financial Coordinator when needed.
• Work with collection attorneys and consultants on outstanding accounts.
• Submit insurance re-credentialing forms as required.
• Generate  reports and provide billing information requested by management.
• Perform the Finance Coordinator’s duties and responsibilities as needed and in the absence of the Finance Coordinator.
• Financial Coordinator assists residents and representatives in completing NYS Medicaid applications
• Financial Coordinator meets with new residents/representatives within 48 hours of admission to review financial obligations
• Coordinate with DSS Case Workers to ensure timely application processing
• Maintain accurate payer source records; report updates to VP of Finance/Administrator
• Financial Coordinator fulfills 3559 county reporting obligations
• Refer complex cases to attorneys and liaise on documentation requirements
• Collaborate with in-house biller on Medicaid status and billing needs
• Handle insurance verifications, pre-authorizations, and financial pre-screening
• Respond to billing inquiries and assist with healthcare provider information requests
• Manage Social Security Representative Payee and Direct Deposit forms
• Complete annual Medicaid and insurance re-certifications (MLTC, Medicare, etc.)
• Participate in weekly UR meetings and share updated insurance information
• Support annual financial reporting, surveys, and audits
• Perform office duties: census entry, mail sorting, UPS scheduling, and file management
• Flexibility to perform additional tasks as assigned

Requirements

• Proven  experience in a skilled nursing facility (SNF), long-term care, or healthcare setting with a focus on medical billing and coding.
• Strong  knowledge of medical terminology and the ability to interpret medical records accurately.
• Proficiency in ICD-9, ICD-10, CPT, and HCPCS coding.
• Experience with Medicare, Medicaid, managed care, and private insurance billing.
• High-level  proficiency with billing software and PC-based applications, including Microsoft Excel.
• Excellent attention to detail, organizational skills, and ability to meet strict deadlines.
• Strong communication skills to effectively interact with patients, insurance providers, and healthcare professionals.
• Commitment to maintaining confidentiality and adherence to HIPAA regulations.
• Ability to work independently as well as in a team-oriented environment.
• Flexibility  to perform additional tasks as assigned.
• Minimum 2 years of Bookkeeping experience and proficiency in NYS Medicaid application processes.
• Excellent communication and organizational abilities.
• Capacity to thrive under pressure and adaptability to changing demands
• Superlative customer service acumen
• Proficient in using billing software and Microsoft Office applications (Excel, Word, Outlook)
• Strong communication skills to effectively interact with patients, insurance providers, and healthcare professionals.
• Ability to work independently as well as in a team-oriented environment.
• Flexibility to perform additional tasks as assigned.
• Commitment to maintaining confidentiality and adherence to HIPAA regulations.
• Excellent communication and interpersonal skills.
• Ability to prioritize responsibilities, meet deadlines, and manage time.
• Covid-19 vaccinations are encouraged but NOT MANDATED; we continue to offer COVID-19 vaccination based on eligibility guidance from CDC.

We are an Equal Opportunity Employer, celebrate diversity, & are committed to creating an inclusive work environment for all! We comply with disability laws and provides reasonable accommodations for applicants and employees. For assistance with the application, interview process, job functions, or employment benefits, contact the facility directly by calling 315-339-2220 and ask to speak to the HR Dept. or email us at [email protected]

*Disclaimer: This is a general job summary for advertisement purposes only. A full comprehensive job description can be provided upon request or during the hiring process.