Responsibilities
- Oversee daily census tracking to verify correct records of admissions, discharges, transfers, insurance changes, and room assignments.
- Use PCC Dashboard tools to monitor and confirm the accuracy of resident census data.
- Confirm patient insurance eligibility, coverage terms, benefit periods, and usage dates.
- Accurately input and manage insurance authorizations in a timely manner.
- Update billing systems and census logs to reflect all changes in payment sources.
- Keep census spreadsheets and internal reporting tools current and error-free.
- Meet all PA Health and Wellness reporting deadlines with complete and correct data.
- Perform 72-hour insurance verification for new residents to identify coverage and billing potential.
- Prepare and submit daily financial deposits according to policy.
- Process check deposits through Bankwell with accuracy and on schedule.
- Reconcile and manage transactions processed via Sola platform.
- Input manual care costs into RFMS when automated entry is not available.
- Enforce internal controls for cash handling and deposit procedures.
- Lead collection efforts for private pay and personal liability accounts, targeting over 95% recovery rate.
- Review monthly resident billing statements for correctness before distribution.
- Ensure monthly invoices are mailed or sent electronically without delay.
- Make consistent and professional follow-up calls on overdue accounts.
- Initiate legal collection actions, including magistrate filings, when needed.
- Handle financial matters and communications related to guardianship accounts.
- Process approved refund requests within 30 days of approval.
- Monitor accounts receivable aging and apply strategies to reduce outstanding balances.
- Engage in the Triple Check process to verify billing accuracy before claims are submitted.
- Audit UB claims for completeness, correctness, compliance with payer rules, and proper documentation.
- Resolve billing errors prior to claim submission to prevent denials.
- Work closely with clinical and admissions staff to support clean claims and fast reimbursement.
Other
- Maintain census and billing accuracy above established standards
- Achieve 95%+ collections on applicable accounts
- Ensure deposits are completed daily and accurately
- Submit clean claims timely
- Process refunds within 30 days
- Maintain regulatory and payor compliance standards
