at Nexion Health Management in Holly Springs, Mississippi, United States
Job Description
Nexion Health is seeking for an experienced Managed Care/ Medicare Biller in our Corporate Office Revenue Cycle department. Nexion Health operates 50 skilled nursing and rehabilitation, as well as assisted living, facilities in Colorado, Louisiana, Mississippi, and Texas. BASIC FUNCTION The Revenue Cycle CBO Biller is responsible for billing, collecting outstanding Accounts Receivable in accordance with Nexion Corporate policy and applicable federal, state, and local regulations. This position reports to the Revenue Cycle CBO Supervisor/ Revenue Cycle CBO Manager. ESSENTIAL FUNCTIONS (Revenue Cycle) The AR Biller will be responsible for billing Managed Care and or Medicare. Essential functions will include: 1. Billing and collection of Managed Care and/or Medicare accounts receivable for a predetermined number of facilities. 2. Daily claim follow up. 3. Post payments and reconcile accounts to ensure payment is correct according to the contract. Adjust applied deductibles and copays to the appropriate payer. 4. Audit accounts for denied claims or partially paid claims and request appeals when applicable. 5. Follow and track ADR requests and communicate outcomes to the Director of Appeals and Denials Management. 6. Other assigned duties according to need. 7. Be willing to travel to Nexion facilities and regional meetings as needed. QUALIFICATIONS 1. Minimum – High School Diploma or equivalent. 2. Strong working knowledge of personal computer and software applications used in job functions (databases, spreadsheets, word processing, etc). 3. Must be able to work independently with strong organizational skills at a fast pac e. EXPERIENCE 1. Must have a minimum of 3 years’ experience billing Managed Care and/or Medicare for Skilled Nursing Facility services. 2. Prefer experience in AR software package – PCC, Trubridge, Microsoft Office. 3. Managed Care biller must be proficient in navigating payer portals such as UHC, Availity, and other Managed Care Portals. 4. Must have experience communicating with Managed Care and/or Medicare payers. 5. Must have a strong understanding of Managed Care and/or Medicare billing for Skilled Nursing Facility services. 6. Must be familiar with UB04 and/or HCFA claim forms. WORKING CONDITIONS 1. This position is located at the Corporate Office in Sykesville, Maryland, or home based if outside of Maryland.: EOE M/F/D/V
