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Position Description

Responsible for supporting the Business Office Manager and the overall management of business office activities in accordance with current applicable federal, state, and local standard guidelines and regulations. Responsible for coordinating with the Business Office Manager on managing insurance payments, including private, Medicare, Medicaid and other managed care; managing refunds for accounts receivable, and maintaining appropriate logs and reports, not limited to, resident funds, census records, and case accounts.

Principal Responsibilities

• Assists in all business functions including but not limited to accounts receivable, accounts payable, resident trust funds and other assigned duties.

• Ensures the financial systems are accurate, efficient, and in accordance with professional accounting practices and governmental.

• Prepares billing documents in accordance with State and Federal rules and regulations pertaining to billing procedures.

• Audits bills for accuracy and assist as assigned with billing corrections. • Files initial and final claims accurately and within acceptable agency timeline.

• Assist as liaison between agency and facility; agency and resident/responsible party.

• Maintain required resident payment records, reports, and files.

• Assist resident and/or responsible parties on billing and upcoming services.

• Assist the business office manager in managing insurance payments of Medicare, Medicaid, private insurance, HMOs and hospice billing; verifies payor source; posting payments to various systems; ensures critical deadlines are met.

• Ensures timely receipts of all payments.

• Notifies residents and families of their financial obligations upon or prior to the time of admissions and obtains proper documentation of each newly-admitted resident’s financial obligations- distributed, signed and filed.

• Makes monthly phone calls to responsible parties regarding missing payments; submits Medicaid applications and completes timely follow up on pending cases; enters admission packets into the electronic system within 7 days of admission.

• Maintains monthly logs for outstanding admission packets, new admissions, verifications and pending cases; maintains Medicaid Pending and Pending admission log.

• Follows facility process for receiving, depositing, withdrawing and accounting for resident funds and ensures that resident funds are available for the resident or their authorized representative in accordance with established procedures; conducts monthly audit to ensure process is followed.

• Tracks Census for accuracy; Balances statistical report, census worksheet, and accounts receivable system census reports; Balances to 24-hour nursing report; Adjusts Accounts Receivable and Statistical Reports, when necessary.

• Obtains face sheet from admissions and verifies accuracy; Inputs Resident Master information into the accounts receivable system; Updates as necessary.

• Assists in preparing reports for tracking cost reimbursement in relation to census days.

• Other duties, responsibilities and activities may change or assigned at any time with or without notice.

Southwest Nursing Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.