Presbyterian Living- Corporate - Med & Third Party Biller - Full Time - (8am-4pm) - Accounting Department | Hybrid
Looking for a team where you can bring your passion, strengths and your best self each day as a Med & Third Party Biller?
Our employees work as one team and aspire to deliver a personalized experience to our residents through collaboration and knowledge sharing of their expertise. We are looking for candidates at Presbyterian Living that like to lead, by example creating a positive work environment and living community experience that inspires wellness, independence, joy and security for our residents and families.
Why YOU Will Love Working With Us
Comprehensive Benefits That Care for You
- Health & Wellness: Medical, dental, vision, Wellhub, and onsite fitness
- Financial Security: PTO rollover/sellback, 403(b) with match, commuter benefits, financial counseling
- Peace of Mind: Life insurance, disability coverage, EAP support
- Growth & Development: Tuition reimbursement, scholarships, mentorship, and career pathways
- Community & Connection: Engagement events and 24/7 chaplain counseling for emotional/spiritual support
- Review and evaluate patient demographic information regarding Medicare, Medicare Advantage, and all third-party billing, including updating payer sequencing.
- Review daily Admission, Discharge and Transfer (ADT) report for changes related to Medicare A, Advantage and Commercial insurance stays and communicate concerns regarding accuracy of said report to appropriate admissions staff.
- Generate and / or import all therapy charges related to Medicare, Advantage, and Commercial insurance services and all other secondary carriers, ensuring claims are submitted timely and in compliance with appropriate regulatory bodies as well as payer specific guidelines.
- Adjudicate charges, adjustments, payments, and denials in order to resolve all discrepancies as they relate to Medicare, Advantage and third-party payers, including all follow-up with any payers regarding claim status to ensure timely collections and minimal uncollectible accounts.
- Work with Business office to transfer balances to residents related to co-payments, deductibles, and patient responsibility as necessary (as they relate to Medicare, Advantage, Commercial and co-insurance services).
- Ensure coding accuracy (including but not limited to PDPM, hospital stay dates, types of bills, diagnosis, etc.) for Medicare A, Advantage A, and third-party payer claims (as they relate to applicable services) and work with applicable departments to resolve errors or inaccurate data.
- Participate in monthly triple-check meetings at all communities to ensure accurate and timely billing as well as regulatory requirements (as they pertain to billing Medicare and Advantage Claims) are being met prior to claims submission.
Skills/Qualifications:
- High School – Advanced degree or working toward advanced degree preferred
- Three to five years of Medicare, Advantage and Third-party billing, DDE experience, claim adjudication and collection experience with emphasis in a Skilled Nursing setting.
- Proficient in Microsoft Office, particularly Excel, and computer billing applications
- Must have ability to work in an electronic billing and information systems environment to ensure that bills are accumulated, reviewed, tested, sent and adjudicated.
- Strong interpersonal skills and able to handle multiple tasks to meet deadlines.
- Strong attention to detail and able to work independently.
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