Responsibilities
- Oversee daily census updates, ensuring precise tracking of admissions, discharges, transfers, insurance changes, and room assignments.
- Use the PCC Dashboard to monitor and confirm the accuracy of census information.
- Confirm patient insurance eligibility, coverage limits, benefit periods, and applicable dates.
- Accurately record and manage authorizations in a timely manner.
- Update billing systems and census records to reflect all payer changes.
- Keep census spreadsheets and internal reporting tools current and error-free.
- Fulfill PA Health and Wellness reporting obligations with accuracy and timeliness.
- Perform 72-hour insurance reviews for new residents to verify coverage and identify billing opportunities.
- Prepare and submit daily financial deposits.
- Ensure Bankwell check deposits are processed correctly and on schedule.
- Reconcile and manage Sola payment transactions.
- Input manual care costs into RFMS when necessary.
- Uphold internal controls for cash handling and deposit procedures.
- Lead collection efforts for Private Pay and PL accounts, targeting 95% or higher recovery rates.
- Review monthly resident statements and invoices for correctness before distribution.
- Ensure monthly billing statements are mailed or sent electronically without delay.
- Conduct professional and consistent follow-ups on overdue accounts.
- Coordinate legal actions such as magistrate filings and court proceedings when collections require escalation.
- Handle account activities related to guardianship, including communication and documentation.
- Process approved refund requests within 30 days of approval.
- Monitor accounts receivable aging reports and implement strategies to reduce outstanding balances.
- Engage in the Triple Check process to verify billing accuracy before claims are submitted.
- Audit UB claims for completeness, compliance, and proper documentation.
- Address and correct billing discrepancies prior to claim submission.
- Work closely with clinical and admissions teams to support accurate billing and prompt 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
