Financial Coordinator - Patient Billing/Reimbursement

Thank you for your interest in our Coordinator position based within our managed subacute unit Poway, CA. This position will begin in a part-time status and potentially develop to full-time. Please be sure to carefully read the job description and requirements below. If you have similar experience, please apply now for consideration.

Responsible for the admission functions of the Subacute unit to include the financial analysis of reimbursement, verification of insurance benefits and the identification of healthcare benefit allowances. Meets with the patient and family members to identify community resources and make referrals as appropriate. Performs all subacute billing and follow up to Medicare, Medi-Cal, contracted payers and self pay patients. Works closely with all hospital departments in the Long Term Care, Subacute, Acute Care and Business Offices. Is knowledgeable of and maintains ongoing compliance with the County, State and Federal regulations and guidelines as they relate to Subacute/SNF admission, authorization and billing requirements.

Perform admitting, financial counseling, billing and collection functions as a contract employee within the subacute units of contracted health facilities working closely with residents and/or their representatives. Administrative liaison to contracted facility personnel for the delivery of quality services which includes, but is not limited to: Administrator, Chief Financial Officer, Business Office Director, Case Manager, MDS Coordinator, Nursing Staff and Social Worker. Serves as a liaison to VitalCare?s executive, direct service and corporate support personnel.

QUALIFICATIONS:

Professional:

POSITION RESPONSIBILITIES:

Direct Service/Skills:

Completing all admission tasks for subacute residents into the facility; assuring the completion of admission agreement, to include the appropriate signatures on consent forms and financial documents; and providing information covering rights and services

Providing financial counseling to residents and/or their responsible parties to explain insurance coverage available, benefit periods, resident liability and payment expectations for subacute services

Managing all necessary admission data, insurance verifications, required documentation, authorizations, and charges are in place for accurate claim submission

Assisting with and monitoring resident?s financial benefits to assure financial security and management of personal funds, application and monitoring of benefits process, liaison to disability and welfare agencies for continuity of coverage.

Making appropriate referrals to HCLS (Health Care Legal Solutions) or contracting company for Medi-Cal eligibility

Preparing and issuing Medicare SNF Determinations on Admission or Determinations on Continued Stay (Denial Letters)

Billing and collecting of resident liability to include but not limited to: coinsurance, deductibles, Medi-Cal SOC (Share of Cost), and cash accounts

Submitting claims timely and efficiently within payer filing limits to secure reimbursement

? Medicare A & B - 1 X month

? Medicare Coinsurance - 1 x month

? Medi-Cal - 2 x month

? Insurance/Other - 1 x month

? Medicare and Medicare HMO No Pay ? per

SNF requirements

Performing bi-monthly account follow up on outstanding balances and monthly reconciliation to ensure payments are accurate and all unit revenue has been captured

Managing accounts, maintaining the billing database for the electronic management systems, and documenting all details in the patient account comments

Analyze facility contract matrix, reimbursement and application of contract terms for subacute accounts

Tracking all subacute TARs (initial, reauth, and bed hold). Initiating reauth and bed hold TARs, forwarding to Subacute Clinical Staff to complete clinical portions. Submitting and monitoring TARs sent to and received back from the Field Office. Provides trouble-shooting assistance in resolving TAR authorization problems.

Maintaining Subacute Logs to include but not limited to: Admissions, Medicare and Medi-Cal Eligibility, SOC Log, Subacute TAR Tracking, Medicare Part B Billing & Reimbursement Tracking, and Subacute Billing & Reimbursement Tracking.

Responding timely to all communications (which includes, but is not limited to, the daily checking of email and voice mail messages) with appropriate follow-up actions.

Coordinates and conducts Subacute business meeting to discuss pertinent billing, payment, status of benefits and follow up concerns to assure resident?s financial security with, or as directed by, Director of Patient Accounts

Follows contract facility rules, policies, procedures, applicable laws, and standards. Responsible to support the mission, vision, values, and quality commitment of contracted facility