Location
Des Moines, IA | United States
Job description
Billing Specialist
Calvin Community is nestled in the heart of Des Moines’s Beaverdale neighborhood. Calvin Community is a not-for-profit senior living community focused on serving older adults in a caring, Christian Community designed to meet their physical, social, spiritual, and psychological needs and contribute to their health, security, and happiness. Calvin Community proudly provides high-quality, compassionate services in independent living, assisted living, skilled nursing, long-term care, and memory support care for residents.
The successful candidate for this position must have knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements in a long-term care setting. The candidate must have excellent written and oral communication skills.
Key Accountabilities of the Medicare Billing Specialist include:
- Entering insurance and co-insurance and responsible party information into billing system and prepare and transmit claims
- Review daily census information
- Review, enter and process of private pay statements including ancillary charges, Medicaid, and Medicare claims.
- Review of and follow-up of all outstanding statements and claims, including private pay, Medicare, Medicaid and co-insurances.
- Assisting with financial information related to long-term care insurance and and/or process long-term care insurance when appropriate.
- Responsible for inquiries from the long-term care insurance companies.
- Assisting with Medicaid and Elderly Waiver applications as needed.
- Review resident statements and correct any missing or inaccurate information
- Use of insurance carrier portals for eligibility and claims information; verifying coverage and eligibility for services provided, work with insurance companies to secure any pre-authorizations required for procedures and/or work with counseling staff to secure or track any pre-authorizations for procedures
- Collects delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occur.
- Entering and balancing of cash receipts.
Requirements and Qualifications:
- Experience with long-term care and healthcare billing.
- Familiarity with CPT, ICD-10, and HCPCS Coding.
- Exceptional Customer Service skills for interacting with patients regarding medical claims and payments, including communication with patients and family members.
- Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
- Knowledge of medical terminology likely to be encountered on medical claims.
- Effective communication abilities for phone contacts with insurance payers to resolve issues.
- Good analytical and problem-solving skills.
Job Type:
Benefits:
- 403(b)
- Voluntary Benefits (Health, Dental, Vision, and Life)
- Employee assistance program
- Flexible spending account
- Paid time off
- Tuition reimbursement
- Discounted staff meals
About Calvin Community: Since 1965, Calvin Community’s success can be attributed to its mission: to provide, on a non-profit basis, services to older adults in a caring, Christian community designed to meet their physical, social spiritual and psychological needs and contribute to their health, security and happiness.
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