CC Administrative Assistant/Biller

Summary 

While upholding the Star Valley Health mission, vision and values, this position is crucial to the flow of the Care Center. The incumbent is responsible for the timely completion of residents’ records, general clerical duties, billing duties and support of the staff. This is handled through professional customer service in person and over the phone to collect data and answer questions. This position is accountable for complying with all policies, procedures and regulations related to billing all payors, both internal to the organization and external. The incumbent will remain in full compliance with all departments, institutional and regulatory, both state and federal, laws at all times. This is an “at-will” position.  

 Job Duties   

· Participates in an open and collaborative relationship between the business office and the care center administrative office, both working toward shared facility goals for occupancy and collections.

· Provides tours of the facility, and as requested by potential residents/representatives.

· Meets with potential residents/representatives and provides information about the facility.

· Ensures pre-admission financial evaluations regarding the identification of a payer source is coordinated as part of the pre-admissions process.

· Ensures residents are admitted, transferred and discharged from the facility EMR accurately. 

· Records residents pay status changes on the facility’s internal daily census communication tool.

· Records residents pay status accurately in the resident’s record at time of admission.

· Works in a helpful and pleasant manner, daily using the telephone to communicate with families, residents, hospitals, insurance companies, etc. related to processing referrals.

· Completes admission paperwork and files according to facility policy.

· Completes the daily census and maintains records according to applicable policy and law. 

· Participates in facility assessment activities as needed, such as carrying out duties assigned as part of a performance improvement committee.

· Participates in the facility’s plan of correction response to an inspection survey and implements any follow-up as designated by the Care Center leadership team.

· Ensure the residents’ records are complete for billing purposes.

· Communicates daily with the Interdisciplinary team to complete financial evaluations for potential residents and payment options including but not limited to printing of the Common Working File, printing Medicaid Eligibility, and identifying the pay status with the resident/representative prior to admitting the resident and ongoing during the residents stay.

· Interacts with physicians and nursing staff to ensure that they have the needed records and reports.

· Ensures monthly billing is completed accurately and timely.

· Ensures the facility’s billing checks and balances are followed by all team members as required by facility policy including but not limited to the balancing of the daily census, Medicare triple check prior to billing, etc.

· Works with the billing office to develop and implement processes and systems to manage billing, collections (A/R), accounts payable (A/P), patient trust, liability notices, purchase orders, and all necessary business transactions using generally accepted accounting principles.

Ensures the Business Office procedures comply with regulatory requirements related to bed-hold notice      

· Participates in an open and collaborative relationship between the business office and the care center administrative office, both working toward shared facility goals for occupancy and collections.

· Provides tours of the facility, and as requested by potential residents/representatives.

· Meets with potential residents/representatives and provides information about the facility.

· Ensures pre-admission financial evaluations regarding the identification of a payer source is coordinated as part of the pre-admissions process.

· Ensures residents are admitted, transferred and discharged from the facility EMR accurately. 

· Records residents pay status changes on the facility’s internal daily census communication tool.

· Records residents pay status accurately in the resident’s record at time of admission.

· Works in a helpful and pleasant manner, daily using the telephone to communicate with families, residents, hospitals, insurance companies, etc. related to processing referrals.

· Completes admission paperwork and files according to facility policy.

· Completes the daily census and maintains records according to applicable policy and law. 

· Participates in facility assessment activities as needed, such as carrying out duties assigned as part of a performance improvement committee.

· Participates in the facility’s plan of correction response to an inspection survey and implements any follow-up as designated by the Care Center leadership team.

· Ensure the residents’ records are complete for billing purposes.

· Communicates daily with the Interdisciplinary team to complete financial evaluations for potential residents and payment   options including but not limited to printing of the Common Working File,   printing Medicaid Eligibility, and identifying the pay status with the resident/representative prior to admitting the resident and ongoing during   the residents stay.

· Interacts with physicians and nursing staff to ensure that they have the needed records and reports.

· Ensures monthly billing is completed accurately and timely.

· Ensures the facility’s billing checks and balances are followed by all team members as required by facility policy including but not limited to the balancing of the daily census, Medicare triple check prior to billing, etc.

· Works with the billing office to develop and implement processes and systems to manage billing, collections (A/R), accounts payable (A/P), patient trust, liability notices, purchase orders, and all necessary business transactions using generally accepted accounting   principles.

· Ensures the Business Office procedures comply with regulatory requirements related to bed-hold notice requirements.

· Processes and researches billing questions in an accurate and timely manner.

· Keeps informed of Medicaid billing updates, policies, and changes.

· Interacts with residents and families to answer questions.

· Works closely with other clinical providers to provide any documentation or information necessary to ensure   proper record keeping.

· Knows, always, which payment entities require prior authorization for payment and secures prior authorization when   required.

· May at times be required to complete mental health screenings as required by federal and state regulations prior   to admission.

· Maintains a working knowledge of the state long term care Medicaid insurance program, Medicare Part A, B and C   insurance program, private long term care insurance programs, Veteran’s Administrative contracts, and hospital contracts, etc.

· Understands, continues to learn, and teaches others about new CMS program initiatives affecting the facility’s   fiscal health such as value-based purchasing programs like SNF-VBP, SNF-QRP, Quality Measures, and Payroll Based Journal reporting, etc.

· Identifies and collaborates with members of the interdisciplinary team, consultants, and others when needed to   identify opportunities for enhanced financial services to the residents and/or resolve issues.

· Collects, assembles, checks, and files resident charts.

· Order and maintain inventory of supplies for resident care and office operations to ensure smooth daily functioning.

· Maintains staff education files.

· Assists with projects and task in the Care Center as needed. 

· Cross trains to assist with workloads and perform other duties as assigned or identified. 

Abilities & Skills: 

· Strong coordination skills to ensure smooth Care Center operations. 

· Collaborates with members of the interdisciplinary team, family members, hospitals and community, etc. in a manner that resolves issues and improves the admissions and billing processes.

· Promote teamwork, mutual respect, and effective communication. Promotes positivity and active daily problem solving.

· Strong organizational and multi-tasking skills.

· Professional customer service background including oral and written communication.

· Sound analytical and problem-solving skills.

· Ability and willingness to read and stay informed regarding developments in the skilled nursing sector and associated support services, regulatory, business practices and other entities potentially influencing the facility’s fiscal health.

· Proficient with Microsoft Word, Excel, Outlook and the general Internet.

· Multi-tasking skills with the ease of changing directions upon request and need.

· Ability to work in a team-oriented environment, communicate effectively, and demonstrate sensitivity to residents, visitors and staff.

· Treats all residents with dignity and respect. Promotes and protects all residents’ rights.  

· Ability to adhere to all facility policies and procedures. Complies with standards of business conduct, and state/federal regulations and guidelines.

· Promotes a cooperative and congenial work environment. 

· Comply with HIPAA and other federal, state and local regulations as well, as maintain the highest degree of confidentiality in client and staff matters.

· Constant sitting, standing, walking, pushing, pulling, bending, reaching, and computer use throughout the day.

· Ability to assist in evacuation of residents during emergency situations.

Ability to bend, stoop, kneel, crouch, perform overhead lifting and perform other common physical movements as needed for the position. 

Experience & Education:

· Bachelor’s or associate degree in   accounting, Business Administration or related field preferred.

· Must have at least three (3) years of   experience in a billing capacity in the business office of a hospital,   nursing home, or other related health care facility.

· Knowledgeable of long-term care and   skilled nursing home regulations, procedures, laws, regulations and guidelines   pertaining to long-term care.

· Knowledgeable of insurance coverage   and authorization process pertaining to long-term care is helpful.