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Skills: Third party billing, Medicare billing, Claims management, Accounts receivable, Customer service
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$26/hr–$36/hr
Full-time
bachelor degree
Medical insurance, Dental insurance, Vision insurance, Employer paid group term life insurance, Disability insurance, Paid time off
Posted 4d ago
~40 hrs/week
Responsibilities
The specialist will prepare, submit, and monitor Medicare and insurance claims while coordinating responses to Additional Development Requests. They are responsible for maintaining accurate accounts receivable records and collaborating with campus personnel to ensure billing compliance.
Requirements
Candidates must possess a bachelor's degree in accounting or a related field, or have at least 5 years of long-term care billing experience. Strong organizational, communication, and interpersonal skills are required to handle routine tasks professionally.
Full job description
We Are Inspired to Serve. Join us!
The Central Office of a nation wide family of Continuing Care Retirement Communities is seeking a Third Party Reimbursement Specialist. This position will provide third party billing services to one or more campuses of Covenant Living. This position will prepare, bill and monitor claims for Medicare Part A, Medicare Part B, Medicare Managed Care (HMO) and coinsurance. In addition, this position will be responsible for overseeing and coordinating the response to the Fiscal Intermediary (FI) or Medicare Administrative Contractor (MAC) to all Additional Development Requests (ADRs) from Medicare or other insurance companies. This position is expected to deliver outstanding accounts receivable results and customer service while maintaining a working relationship with the on-site campus personnel.
Location: Skokie, IL (Hybrid). Enjoy the flexibility of a hybrid schedule with work-from-home options, while collaborating with our Central Office and community teams.
In this role, the Third Party Reimbursement Specialist will:
Obtain monthly reports from the assigned campus(es) in order to determine and carry out the billing needs;
Prepare, review and submit individual resident claims for Medicare Part A, Medicare Part B, coinsurance, Medicare Managed Care (HMO) or Private Fee-for-Service(PFFS) and others as needed;
Rely on Medicare’s cross-over billing when available, and collaboration with Healthcare Billing Assistant for follow-up with a paper claim, only when claim is outstanding after 60 days;
Track, generate and submit Benefit Exhaust and No-Pay claims for assigned campus(es);
Track, generating and submitting denial claims, denial for insurance claims or if special requirements exist at assigned campus(es);
Submit and monitoring of all resident claims on a timely basis;
Record of Medicare payments in the Vision system after Electronic Remittance Advice (ERA) import; Upload all Medicare Part A and B claims to UB Watch and use resulting data to ensure accurate billing.
Propose adjustments and write offs, per CL Policy 5201, to ensure accurate representation of the aging at any point in time;
Review of Medicare Part B therapy log, as needed, to ensure proper diagnosis code information is entered under Medicare Part B payer in Vision.
The ideal candidate will have:
Bachelor of Arts or Science degree in Accounting, Healthcare or related field and/or 5 years of long term care billing experience, required.
Good inter-personal relationship skills and the ability to deal well with others and handle a variety of routine tasks and responsibilities in a professional, prompt manner.
Excellent organizational skills, initiative and good judgment, accuracy and attention to detail.
Ability to work collaboratively and effectively with campus staff via telephone and email.
Tact and posses excellent communication skills (written and verbal, English skills required) to effectively Genuine compassion for senior adults and the disabled, project a friendly character, support customer service and team concepts.
Compensation Pay Range:
$26.92 - $36.23 per hour
Reasonable Pay Estimate
A reasonable estimate of the pay range for this position is $26.92 - $36.23 per hour. There are numerous factors taken into consideration in determining the actual offered rate of pay, including but not limited to: job-related qualifications, experience, skills, education, geographic location, and consideration of internal and external equity.
For full time employees, we offer a generous benefits package that includes:
Medical, dental and vision insurance
Employer paid group term life and disability
Paid Time Off (PTO) & six paid holidays
403(b) with a 3% employer match
Fitness center use at most facilities.
Various voluntary benefits:
Life, AD&D
Tuition assistance and scholarships
Employee assistance program
Legal services, home/auto insurance, discount purchasing program
Covenant Living and CovenantCare Home Health and Hospice are equal opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin or ancestry, age, disability, marital status, pregnancy, protected veteran status, protected genetic information, or any other characteristics protected by local laws, regulations, or ordinances.
Related keywords
Third Party ReimbursementMedicare Part AMedicare Part BHMOPFFSAccounts ReceivableBillingClaimsLong Term CareVision SystemUB WatchERAADRFiscal IntermediaryMedicare Administrative ContractorAccounting
CovenantCare at Home is an award-winning, non-profit, licensed Home Health agency.
Industry
Hospitals and Health Care
Company size
201-500 employees
Headquarters
Turlock, CA
LinkedIn followers
2,211
CovenantCare at Home is an award-winning, non-profit, licensed Home Health agency. It provides Medicare Home Health and Personal Assistance at home. It is the Home Health agency in the Covenant Church's family of services. And, it is affiliated with Covenant Retirement Communities, which are among the ministries of the national Covenant Church.
CovenantCare at Home is a product of a Christian heritage of service. It is a home care agency that makes a difference in the lives of its clients and their families.
Our skilled, Home Health professionals customize plans of care that are developed in collaboration with physicians, other members of your health care, and your specific needs and desires.
CovenantCare's Hospice Care has two simple objectives: improve the qulaity of life for those facing a life-limiting illness while providing much needed education and support for their loved ones. In doing so, we manage symptoms and pain in a way that provides comfort while the patient can benefit from the company of their loved ones.
We offer, Home Health, Hospice, Pallaitve Care, and Private Duty services.
The Company delivers on its brand promise:
Exceptional care. At home. Our promise.
The Company delivers on its brand promise:
Exceptional care. At home. Our promise.
Offices: 1550 Fulkerth, Turlock, CA 95380, US · 5700 old orchard rd, Skokie, Illinois 60077, US · ppp, Westminster, Colorado 80031, US · pp, Geneva, Illinois 60134, US
Medicare certified; personal care and private duty; hospice and palliative care; pediatric care; complete senior case management.Health Care
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