Accounts Receivable Clerk

Phoenix Senior Living•Lexington, KY

7d•Onsite

About The Position

Lexington Country Place is seeking an Accounts Receivable Clerk to join our team! The Accounts Receivable Clerk is responsible for the timely and accurate billing, collection, and reconciliation of resident accounts within a skilled nursing facility. This position manages accounts receivable for Medicare, Medicaid, managed care, hospice, VA, and private-pay residents while ensuring compliance with federal and state regulations, payer requirements, and facility policies. The Accounts Receivable Clerk works collaboratively with Admissions, Case Management, Medical Records, Therapy, Nursing, and Finance to maximize reimbursement and maintain accurate resident financial records.

Requirements

Proficiency in accounts receivable processes within a skilled nursing facility.
Knowledge of Medicare, Medicaid, managed care, hospice, VA, and private-pay billing.
Understanding of federal and state regulations, payer requirements, and facility policies.
Ability to work collaboratively with various departments (Admissions, Case Management, Medical Records, Therapy, Nursing, Finance).
Experience in claim preparation and submission.
Skills in payment posting, adjustment, denial, and correction processing.
Proficiency in reviewing accounts receivable aging reports and following up on outstanding balances.
Ability to research and resolve billing discrepancies and payment issues.
Experience in coordinating with insurance companies and government agencies.
Strong documentation skills.
Experience in verifying insurance coverage, benefits, authorizations, and eligibility.
Familiarity with month-end close activities.
Knowledge of CMS regulations, HIPAA, and Medicare/Medicaid billing guidelines.
Ability to participate in audits and resolve findings.
Effective communication skills for interdisciplinary team collaboration.
Ability to assist residents and families with billing inquiries.

Responsibilities

Prepare and submit timely and accurate claims for Medicare Part A, Medicaid, managed care organizations, hospice, private pay, and other third-party payers.
Monitor resident accounts to ensure timely payment and appropriate reimbursement.
Post payments, contractual adjustments, denials, refunds, and account corrections accurately.
Review accounts receivable aging reports and aggressively follow up on outstanding balances.
Research and resolve billing discrepancies, claim rejections, payment delays, and denials.
Work with insurance companies, Medicaid agencies, managed care organizations, and responsible parties to resolve payment issues.
Maintain complete documentation supporting all billing and collection activities.
Coordinate with Admissions to ensure payer sources, authorizations, and resident demographic information are accurate.
Assist residents and family members with billing questions, account balances, payment options, and financial responsibilities.
Support Medicaid application and pending processes by coordinating with residents, families, and eligibility workers.
Verify insurance coverage, benefits, authorizations, and eligibility as required.
Prepare monthly accounts receivable reports and assist with month-end close activities.
Maintain compliance with CMS regulations, HIPAA, Medicare and Medicaid billing guidelines, and facility policies.
Participate in audits by providing requested documentation and resolving audit findings.
Communicate effectively with interdisciplinary team members to resolve reimbursement issues.
Perform additional duties as assigned by the Business Office Manager or Administrator.