The LTC Account Associate maintains, prepares and processes billing records and bills for CentraState Healthcare System affiliates.
- Prepares and submits bills according to individual payor requirements.
- Reviews appropriate literature in order to stay informed of issues and developments in the field.
- Makes suggestions for software improvements.
- Reviews system generated data for accuracy and makes corrections as needed.
- Maintains accurate records of dollars and accounts billed by payor.
- Provides additional information requested by payors including Medical Records, Medicaid claim correction forms and claim adjustment forms.
- Posts allowances or adjustments to accounts according to payor contracts and/or System policy.
- Prepares monthly statements for resident/resident payment balances.
- Prepares accurate bank deposits for Personal Needs Accounts.
- Sends adjusted bills with balance due to responsible payor or patient/resident as appropriate, following established procedure.
- Manages PNA in accordance with the Medicaid waiver program requirements.
- Maintains a cash receipts journal for all cash deposits.
- Brings unresolved issues to the attention of the Supervisor or Administrator.
- Investigates and responds to patient billing questions received by mail, phone, or in person in a timely manner.
- Demonstrates compassion and understanding when communicating with residents and/or family members.
- Identifies and records software or hardware problems and contacts the vendor for resolution.
- Maintains detailed daily facility census activity data and submits to appropriate regulatory agencies and facility staff.
- Reviews charges for reasonableness and researches questionable or late charges with appropriate departments.
- Prepares accurate reports and statistics as assigned by Coordinator.
- Coordinates, locates and organizes accounts and other documentation for internal, payor and other audits as requested.
- Maintains a resident file for resident billing purposes.
- Monitors accounts and Accounts Receivable reports to identify accounts which require follow-up, adjustment, rebilling, refund, etc and perform indicated duties.
- Actively participates in the collection of delinquent resident accounts by making phone calls, sending notices, etc.
- Advises Resident A/R-Supervisor of delinquent accounts promptly.
- Identifies resident balances which are eligible for placement with an attorney or collection agency and provides documentation to Resident A/R Supervisor.
- Provides information to residents and/or responsible party regarding Medicaid waiver program information and low and moderate income housing requirements.
- Communicates with regulatory agencies to effectuate prompt Medicaid enrollment.
- Notifies appropriate parties as changes related to Medicaid eligibility occur; including income changes and verification of information.
- Posts routine and exceptional charges based on information provided by clinical staff and outside vendors promptly and accurately.
- High School Diploma or Equivalent
- Sub-Acute/Long-Term Care Experience
Required Knowledge and Skills:
- Medical and long term care/sub-acute billing experience preferred. Ability to work with figures accurately and PC experience required. Strong customer service skills.
- No expected exposure to blood and/or body fluids
Standing/Walking – Rarely
Kneeling/Stooping – Rarely
Bending/Climbing – Rarely
Reaching above shoulder, at waist or below waist – Rarely
Lifting/Pushing or Pulling up to 40 pounds
Lifting/Pushing or Pulling over 40 pounds
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
At CentraState, we welcome and promote the diversity of our employee family! Each unique person contributes to the overall success of this organization. Our inclusive culture fosters an environment of professionalism and respect for personal differences.
Additionally, CentraState Healthcare System prohibits discrimination based on arbitrary consideration of such characteristics such as race, color, religion, national origin, ancestry, gender (including pregnancy), affectual or sexual orientation, gender identity or expression, marital status, age, physical or mental disability or limitation, medical condition, genetic information, or veteran or military status, as well as any other legally protected class of persons and acts, in accordance with applicable State and Federal laws.