Medicare Biller / Accounts Receivable

Communicare Health Services - Indianapolis, IN

Full-time

Indianapolis, IN

1,001-5,000 employees

Social Assistance

About the position

The Medicare Biller position at CommuniCare Health Services is a vital role within the Central Billing Office located in Cincinnati, OH. This position is responsible for managing billing, receivables auditing, and collections activities for services provided to patients in various facilities. The Medicare Biller plays a crucial role in ensuring that cash collection goals are met each month while minimizing the impact of bad debt for the assigned buildings and facilities. The role requires a thorough understanding of Medicare and secondary billing guidelines, as well as the ability to interact effectively with insurance companies to resolve unpaid claims. As part of the responsibilities, the Medicare Biller will verify the receipt of monthly triple check forms and audit them for accuracy before claims submission. They will review various types of Medicare claims, including Medicare A, Medicare B, and Medicare Secondary Payer claims, ensuring timely submission according to established billing guidelines. The position also involves daily cash posting of Medicare and secondary payments, follow-up on unpaid claims, and documentation of accounts within the standard billing cycle timeframe. Additionally, the Medicare Biller will monitor for Medicare additional development requests and conduct account research and analysis as needed. The role requires strong verbal and written communication skills to effectively interact with facility staff and insurance companies. The Medicare Biller will also participate in monthly accounts receivable reviews and the month-end close process, ensuring that all billing activities are completed accurately and efficiently. Overall, this position is essential for maintaining the financial health of the facilities served by CommuniCare Health Services, contributing to the company's mission of providing superior management services in adult living communities.

Responsibilities

• Billing and receivables auditing for services provided to patients.
• Collections activities to meet cash collection goals each month.
• Verify receipt of monthly triple check forms and audit for accuracy prior to claims submission.
• Review Medicare A, Medicare A No Pays/Benefit Exhaust, Medicare B, and Medicare Secondary Payer claims for accuracy and timely submission.
• Submission of Medicare Advantage Copy claims and identify secondary claims for billing.
• Daily cash posting of Medicare and Secondary payments per policy.
• Follow-up on unpaid claims and document accounts within standard billing cycle time frame.
• Monitor and report Medicare additional development requests (ADRs).
• Identify and submit necessary rebilling for secondary/tertiary claims during follow-up.
• Conduct account research and analysis and submit write-offs for uncollectable accounts.
• Prepare and maintain various reports including Monthly Cash Report and Credit Balance Report.
• Interact with facility staff to resolve outstanding issues and participate in monthly A/R reviews.
• Participate in the month-end close process and perform other various duties as assigned.

Requirements

• Knowledge of Medicare & Secondary Billing Guidelines.
• Previous experience billing various Medicare and Co-insurance companies.
• Claims appeal/resolution expertise preferred.
• 2 - 4 years advanced education beyond high school, or comparable work experience.
• Strong verbal and written communication skills.
• Professional appearance and mannerisms.
• Ability to work as part of a team.
• Computer skills including Microsoft Word, Excel, and Outlook.
• Knowledge of Medicare DDE, e-Solutions, Point Click Care and Quadax preferred.

Nice-to-haves

• Experience with claims appeal and resolution processes.
• Familiarity with Medicare DDE and e-Solutions.

Benefits

• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance