The Accounts Receivable Coordinator - Hospice is responsible for all aspects of billing and collection of funds for services provided to home health & hospice patients that are funded by Medicare, Medicaid, managed Medicare, managed Medicaid, and all other commercial insurance companies, other federal, state, county, local programs, and direct billing and collections of amounts due directly from the patients/consumers in accordance with company standards and federal, state, and local standards, guidelines, and regulations.
Essential Activities and Tasks
Billing and Collections
Maintain, obtain, retain and apply knowledge regarding the specific billing requirements for Medicare, Medicaid, all other third party commercial insurance funding sources; other federal, state, county, local programs; and, direct billing and collections of amounts due directly from the patients/consumers.
Prepare and transmit all claims electronically using specified software, as well as insurance carrier and other governmental agency internet portals within established monthly billing performance timeframe and by prescribed due dates. This includes billing primary and secondary third party agencies.
Review and balance all assigned ancillary service files provided by various vendors by the prescribed dates for the month end close billing cycle to ensure all ancillary services are captured in billing files to enable accurate claims.
Ensure that all required documents are scanned into the electronic medical record for the date required prior to claims release. Adhere to supervisory internal control review requirements before release of claims.
Validate payer data for patients that intake personnel identified to ensure the proper third party payer, as indicated by the payer guide, and make corrections when necessary.
Validate that required precertification, preauthorization, authorization and re-authorizations were obtained in order to communicate with site personnel to take appropriate action to minimize uncollectible accounts receivable.
Identify and escalate site or payer related issues to supervisor/manager in a timely manner.
Monitor status of collections and appropriate cash receipt application to correct patient account balances.
Identify denied claims on a daily basis. Research, correct and resubmit claims on a daily basis via prescribed software, third party and government agency internet portals, or mail if only option. Escalate any continuing or complicated matters to supervisor/manager for additional attention and potential consultant advisory.
Communicate with third party and governmental agencies to facilitate successful correction and payment of claims when necessary. Communicate with site representatives when necessary to assist in resolution of denied claims.
Assemble information to enable responses to additional development requests to support clinical necessity of claims, and for cases where grievance or appeal is appropriate. Communicate with site and corporate representatives as necessary to facilitate responses to third party agencies. Track and report status.
Prepare, review and release private pay invoice statements, using specified software, within established monthly billing performance timeframe and by prescribed due dates. Invoice statements should be completely accurate with minimal and infrequent errors subsequently discovered. Adhere to supervisory internal control review requirements before release of claims. Established supporting documents or special statement inserts must be included in the mailing.
Field incoming patient, consumer, and/or appropriate family member or guardian calls or emails in a professional and responsive manner. Perform appropriate account research and activity verification. Develop thoughtful and accurate response and send to inquirer. Escalate more complex matters to supervisor/manager when appropriate.
Make collection calls at prescribed intervals. Prepare and send collection letters at prescribed intervals. Develop payment plan options when appropriate and within prescribed guidelines. Refer certain accounts to attorneys or collection agency upon supervisor/manager approval.
Review accounts receivable aging reports to identify outstanding balances and take appropriated action to research and resolve outstanding balances. Goals for overall days in accounts receivable, targeted outstanding balances needing resolution and expecting timing will be established on a monthly basis by supervisor/manager.
Financial Management and Support
Prepare and provide for review and approval all accounts receivable write-off and other types of revenue or receivable balance adjustments as needed with all required supporting documentation.
Identify and notify supervisor/manager of other potential issues through use of various reports that may indicate the need to make revenue, receivable, payer, or rate corrections to ensure that revenue and receivables are recorded accurately and timely.
Identify and offer suggestions pertaining to process improvements.
Communicate collaboratively with other account receivable coordinators to resolve any common patient/consumer receivable matters.
Successfully transition through payer education requirements by pre-determined deadlines, including all payer facility contracting relationships, payer rules and regulations and payer appeals and grievances process.
Participate in recurring team meetings and trainings. Assist and/or be present for site personnel trainings.
Prepares other special reports and performs other tasks or projects as requested and/or required.
High school diploma or equivalent required.
Associate degree in a related field preferred, accounting coursework or concentration desired.
Three years experience performing billing operations preferred.
Experience in home health, hospice, or long-term care healthcare accounting required.
Experience with accounts receivables analytics preferred.
Proficiency with Windows, Microsoft Office (Word, Excel, PowerPoint), and the internet required.
Internal Number: 3772
About Ohio Living
Ohio Living is among the country's leading comprehensive resources on aging well. Our Ohio-based services range from a variety of housing options in one of our life plan communities through the full continuum of care to post-acute home health and hospice support for adults, wherever they live. Most importantly, we’re a company that:
• chooses to operate as a faith-based, not-for-profit organization
• makes its mission the heart of our organization
• has a reputation for consistently exceeding the needs and expectations of those we serve
• provides an engaging, team-oriented workplace dedicated to career, family and faith
• commits to recognizing our employees for a job well done
We’re looking for people who:
• have a passion for helping people, solving problems and contributing to a positive work environment
• are excited about bringing their personal standards and ideals to work each day
• understand that HOW you do your job is just as important as WHAT you do in your job
Why work at Ohio Living?
Depending on an employee’s full-time, part-time or PRN status, they may benefit from:
• competitive wages
• affordable medical, dental, and vision insurance
• 4...03b retirement savings
• paid time off including your birthday
• training, continuing education, and education assistance
• pay advances up to $500
• the latest technology
• unlimited career opportunities
• and much more!
Who is Ohio Living?
Headquartered in Columbus, Ohio Living is one of the nation’s largest not-for-profit, multi-site senior living organizations. Since its founding in 1922, Ohio Living has defined the highest standards of quality of life for adults through its 13 life plan communities and Ohio Living Home Health & Hospice.
Our mission is to provide adults with caring and quality services toward the enhancement of physical, mental and spiritual well-being consistent with the Christian Gospel.
Care • Integrity • Customer Service
Innovation • Financial Stewardship • Leadership
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