Accounts Receivable Coordinator - Private Pay

It's fun to work in a company where people truly BELIEVE in what they're doing!

Our intention is to have employees who are passionate about making their personal mission statement come to life each day at work! Be it through providing healing, eradicating loneliness, contributing to efficiencies, streamlining processes, being dependable, sparking creativity or something else, the demonstration of HOW you do your job is just as important as WHAT you do in your job.

Alongside our valued employees, we are making a difference throughout the state of Ohio in the lives of those that need healthcare or those embracing the next chapter of their lives. Sustained members of our team demonstrate accountable behavior and share our values of customer service, innovation, inclusion, integrity, financial stewardship, leadership and care.

The Accounts Receivable Coordinator-Private Pay is responsible for all aspects of billing and collection of funds for services provided to residents and patients in our life plan communities that are paid for directly by the patient, resident, family member, or appointed guardian in accordance with company standards and federal, state, and local standards, guidelines, and regulations.

Essential Activities and Tasks

Billing and Collections - 90%

• 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. Identify appropriate party for which refunds should be made.

Financial Management and Support - 10%

• 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.

All other duties as assigned.

Qualifications

Education

• High school diploma or equivalent required.

• Associate degree in a related field preferred, accounting coursework or concentration desired.

Experience

• Three years experience performing billing operations preferred.

• Experience in long-term care, hospital, or other related healthcare accounting preferred.

• Experience with accounts receivables analytics preferred.

• Proficiency with Windows, Microsoft Office (Word, Excel, PowerPoint), and the internet required.

Other Requirements

• Must be able to read, write, speak, and understand the English language.

Working Conditions and Special Requirements

• Sitting - Up to 8 hours/day

• Standing - Up to 2 hours/day

• Walking - Up to 2 hours/day

• Lifting, transferring, pushing or pulling equipment/supplies - Up to 25 pounds

• Driving - Up to 6 hours/day

• Work weekends, evenings, and holidays - As needed for coverage

• Risk Category for Exposure to Bloodborne Diseases - III