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Ohio Living · 3 weeks ago

Accounts Receivable Coordinator - Private Pay

Greater Cleveland

Full-time

Onsite

Mid Level

3+ years exp

Ohio Living is a company dedicated to making a difference in the lives of those needing healthcare. The Accounts Receivable Coordinator - Private Pay is responsible for managing billing and collections for services provided to residents and patients, ensuring compliance with company standards and regulations.

Health CareHome Health CareHospitalNon Profit

Responsibilities

Maintain, obtain, retain and apply knowledge regarding the specific billing requirements established by management applicable for private pay billing to and collections from residents/patients of the Communities’ independent living, assisted living, skilled nursing, outpatient or other ancillary service settings. This includes developing and maintaining working knowledge of the primary revenue, receivables, receipts, billing, and medical records software to enable efficient and effective use

Complete all routine daily and monthly processes pertaining to census verification and validation. Interact with site representatives to clarify and/or correct any census discrepancies

Perform certain tasks pertaining to monitoring status of level of care approval/denial by local area offices of aging, Medicaid application approval/denial by County Offices of Medicaid, and receipt of all required documentation to enable Medicaid billing to occur. This includes frequent interaction with Communities’ site representatives, patients or their family members and/or guardians, and governmental agency representatives. Maintain quality documentation of interaction with site and patient/resident or their representatives within the notes section of the primary software

Perform certain tasks relating to verifying patient liability amounts (e.g. personal funds available) for Medicaid beneficiary patients/residents at prescribed timing

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 included into the electronic medical record within prescribed timelines. This includes approved Cost of Care packets, approved Life Care Application packets, consummated Residency Agreements and certain other documents as applicable

Monitor status of collections and appropriate cash receipt application to correct resident and patient account balances. This includes receipt of explanation of benefits from primary or secondary health insurance coverage (e.g. Medicare, managed care plans, etc.), to enable the identification of coinsurance that should be included on the current month end close private pay invoice statements

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

Identify and escalate significant site performance, ancillary vendor data performance, or contested invoice accuracy issues to supervisor/manager in a timely manner

Field incoming patient, resident, 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

Review accounts receivable aging reports to identify outstanding balances and take appropriate 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

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 on a prescribed timing frequency such that refunds can be identified, verified and paid on a reasonably timely basis. Identify appropriate party for which refunds should be made

Prepare for and participate in monthly calls with designated corporate and site representatives to review accounts receivable hot list for private pay receivables and for those that are Medicaid pending. Make recommendations for additional action including notice of discharge. Document all communication with sites in resident notes within primary software

Process refundable entrance fee refunds as approved by site and other corporate management representatives

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 the account receivable coordinators – third party to resolve any common patient/resident receivable matters

Successfully transition through trainings and education requirements by pre-determined deadlines

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

Qualification

Billing operationsAccounts receivables analyticsHealthcare accountingMicrosoft OfficeCommunication skillsProblem-solving skillsTeam collaborationAttention to detail