Billing Specialist
Full Time | Day Shift | 8am-4:30pm | Monday-Friday
Pay rate starting at $20/hour
The Wesley Community is no longer requiring employees to be vaccinated for COVID-19!
Everything we do at The Wesley Community is guided by our Core Values which form the acronym "CARES". These Core Values are COMPASSION, ACCOUNTABILITY, RESPECT, EXCELLENCE and SPIRIT. It's more than a job: it's caring that starts in the heart.
What will I do as a Billing Specialist for The Wesley Community?
- Process mail and correspondence pertaining to your position.
- Make written and oral reports/recommendations to the Resident Financial Services Manager about office operations and accounting procedures.
- Assist in standardizing the methods in which will be accomplished.
- Maintain Business Office files as they pertain to your position.
- Assist in preparing financial and statistical reports as directed.
- Assist in preparing and implementation of changes in our accounting system as necessary or directed.
- Assist with reports necessary to prepare monthly financial statements.
- Perform functions of computer/data processor as necessary.
- Perform general secretarial/clerical duties including but not limited to typing, filing, faxing, and word processing as necessary or directed.
- Answer office phones; refer callers to appropriate person.
- Provide coverage or assistance for any/all Business Assistants out of the office or as directed by the RFSM.
- Assist residents in conducting transactions regarding their resident accounts in absence of the Cash Receipts Business Assistant.
- Respond to residents, employees, families, visitors, etc. in a friendly and courteous manner.
- Assist the CFO and Controller with audits for all corporations.
- Post general ledger information for all corporations.
- Perform general, administrative duties as specifically assigned by the CFO, Controller or Resident Financial Services Manager.
- Other work assigned by Resident Financial Services Manager or that become necessary.
- Generate monthly Room Board and Ancillary charges in EMR MyUnity for Wesley, Woodlawn, and Embury.
- Verify MyUnity Census AR Recon report reflects all days booked for month.
- Run Wesley monthly NAMI billing cycle in MyUnity as well as capturing NAMI recurring charges after end of month census is complete.
- Produce, review and mail monthly private pay/resident income/Medicaid Pending statements for Wesley and Woodlawn.
- Follow up on private pay collections; produce late notices, Transworld collection transfers and payment plans as needed for Wesley.
- Review rates/levels with HMO's payers prior to Wesley billing each month.
- Prepare and produce all Wesley primary billing for Medicare, HMO, VA, MLTC as well as secondary Medicaid claims monthly.
- Prepare/submit Wesley Medicare no pay claims to Medicare on a monthly basis.
- Prepare/submit Wesley Medicaid claims weekly.
- Enter all Wesley Hospice admissions and discharges into MyUnity.
- Make billing status changes to reflect payer class and census changes.
- Aid and assist families through the process of Medicaid and other insurance coverage.
- Prepare resident Medicaid recertifications annually.
- Weekly review of Wesley Medicaid, Medicare and other insurance remits to reprocess or adjust claims as needed per payer guidelines and timeframes and report concerns to Billing Manager weekly.
- Handle all Wesley correspondence from residents, Medicaid, Medicare, Commercial Ins, MLTC and VA in a timely manner.
- Handle all Woodlawn correspondence.
- Daily review of Waystar dashboard to ensure insurance claims are submitted correctly, and denials/adjustments/copays/appeals are processed timely.
- Weekly submission to Waystar of resident insurance payer batch eligibility.
- Maintain Wesley resident insurance information (new enrollments/disenrollment) and update in MyUnity to ensure accurate billing information is always on file; notify Medicaid as necessary.
- Complete a bi-weekly update of all Wesley Medicaid pending cases, follow up with family, Elevate, Summit etc. and ensure NAMI's are being billed on all Medicaid pending cases.
Billing Specialist Requirements:
- High School graduation or equivalency, required.
- Minimum of 2 years' experience in medical billing required.
- Experience in a Skilled Nursing facility billing preferred.
- Experience in Medicare, Medicaid and Commercial insurance plans required.
- Extensive experience with Microsoft Office required.
The Wesley Community strives to have its employees be part of this culture of excellence, to enjoy their work and be rewarded for their superior efforts and performance.
We offer competitive and team-focused Employee Benefits to include:
- Competitive pay + incentive compensation
- A full benefit package
- Paid vacation, sick, and personal time
- Paid Holidays
- Flexible scheduling options
- NEW, Daily Pay Option
- A 401K retirement plan
- Tuition assistance and nursing scholarships
- Opportunities for growth and development
- A caring and supportive teamwork environment
- Perks such as self-care support and on-site prescription fills
- A fun work environment including theme weeks, recognition events, and opportunities for staff involvement
- Member of The National Association of Health Care Assistants (NAHCA)
About the Wesley Community:
For over 40 years, The Wesley Community has provided services and programs with a commitment to compassion, caring and excellence. Our distinctive continuum of care offers a unique balance of community living and caregiving that ensures quality of life at every stage of life.
We are a mission-driven, not-for-profit organization that puts people first. We are proud of our reputation for excellence, innovation, and a personal approach to care and services. We encourage and support our residents in their efforts to achieve their goals, and we treat them respectfully.
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