Responsible to: Medicare Insurance Supervisor. Communicates with all necessary team members.
• Individual must possess an associate degree or higher
• Billing/collection experience preferred
• Computer literate
• Good communication and writing skills
• Must have some accounting background.
• Must be able to read, speak and understand the English language.
• Must have the ability to sit, stand, walk, stoop and reach, and to use hands to manipulate the computer, writing, calculation or other instruments to carry out responsibilities of the position.
• Must be able to lift objects up to 20 pounds.
• Must have adequate vision to perform essential job functions.
• Every employee in the Lexington Network must adhere to and uphold the standards
set forth in our culture contract. Our common purpose, quality standards and behavioral expectations are what set us apart from other organizations. Every interaction must be approached using the ICARE expected behaviors so that every employee and resident will be treated with respect.
• Responsible for billing and collection of Medicare Part A and B co-insurance claims.
• Daily billing of Co-insurance Part-A and B to supplemental insurance
• Collection of co-insurance billing within 30 days from date of billing
• Reconciliation with A/R aging the Co-insurance Part and B logs by the end of the month
• Partner with Royal and facility to expedite accurate co-insurance billing
• Facilitate insurance requests with Royal and facility designee
• Completion of Medicare ancillaries data entry for billing by the 6th
• Completion of Medicare documentation for Part-A PA Co-insurance write-offs monthly.
• Completion of Co-insurance logs by the end of the month
• Completion of all tasks assigned
• Check daily ERA reports for cross over billing and co-insurance portion
• Prepare and mail daily co-insurance billing for Part-A and Part-B. This includes checking the UB for completeness and accuracy of information.
• Call insurance company for cross over claims to ensure processing of payment.
• Follow-up call to insurance companies/check website three weeks after claims are mailed.
• Follow-up with facility designee insurance requests such as Medical records and have records reviewed by VP of Reimbursement. Mail requested records and maintain copy in the file.
• Update Part A PA Co-insurance logs for cost report for required information such as payer types, Medicaid number, payments, etc.
• Completion and printing of Medicare ERA documentation for PA/CIA write-off
• Inform and coordinate with RAC denials from Insurance due to termination or non-coverage of insurance and any insurance issues. RAC updates the financial coverage
• Prepare and submit to supervisor for approval billing adjustments for posting by RAC.
• Reconcile A/R aging with Part-A and Part B logs
• Update 180 days and over control log for current collection updates
• Enter Medicare Part-A ancillaries during billing
• Update No pay bill/exhausted log for Medicare A patients who are off/exhausted in the current month and still at the facility. Also update the discharge/expired dates of existing patient per log.
• Update Medicare payments daily per ERA reports including zero ERAs ( offsetting debit/credits) and ensure a copy is given to RAC. Reconcile total Medicare payments per ERA and A/R (GL#169400).
• Assisting other team members when necessary
• All other duties as assigned
Lexington Health Care - 18 months ago
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