Accountant

$60,507 - $60,507/Yr

Fourans - Paramus, NJ

Full-time - Entry Level

Paramus, NJ

Professional, Scientific, and Technical Services

About the position

The Accountant position at FOURANS LLC involves managing the reimbursement process from Medicare and private insurance for skilled nursing care. The role requires a thorough understanding of medical billing, compliance with Medicare guidelines, and effective communication with various stakeholders to ensure accurate billing and reimbursement for services provided.

Responsibilities

• Obtain reimbursement from Medicare and private insurance companies for skilled nursing care.
• Establish costs for medical services and calculate rates based on the Medicare Fee Schedule.
• Process Part A claims in compliance with Medicare guidelines and NJ Administrative Code regulations.
• Review and implement rules, regulations, policies, and procedures regarding Medicare billing.
• Attend weekly meetings to review residents' level of care and billing status.
• Determine available SNF days and project when patients will exhaust their benefits.
• Change resident care levels from private to Medicare as needed.
• Update reimbursement records to reflect Medicare as the primary payer.
• Verify qualifying hospital stays for residents.
• Implement appropriate medical coding and apply to the UB-04 form for reimbursement.
• Verify accuracy of ICD-10 Codes prior to claims submission.
• Receive PDPM classification model and calculate rates according to the Medicare Fee Schedule.
• Provide ancillary vendors with Medicare Part A Census Report.
• Determine accurate charges for ancillary vendors and reconcile invoices.
• Calculate charges and create electronic files for submission to Medicare.
• Rectify error log reports and correct identified errors.

Requirements

• Experience in medical billing and reimbursement processes, particularly with Medicare and private insurance.
• Knowledge of ICD-10 coding and Medicare Fee Schedule regulations.
• Ability to interpret and implement Medicare guidelines and NJ Administrative Code regulations.
• Strong analytical skills to determine patient benefit periods and reimbursement levels.
• Excellent communication skills for collaboration with nursing and ancillary departments.

Nice-to-haves

• Experience with electronic billing systems.
• Familiarity with the Patient Driven Payment Model (PDPM).
• Previous work in skilled nursing facilities or similar healthcare environments.

Benefits

• Competitive hourly pay of $29.09.
• Flexible work schedule from Monday to Friday.