Billing Associate - Crown Pointe Estates

Avera • Sioux Center, IA

8d • Onsite

About The Position

The Billing Associate is responsible for coordinating resident billing, insurance verification, reimbursement processes, and financial counseling services for residents and their families. This position serves as a key resource regarding Medicare, Medicaid, private insurance, managed care plans, and private-pay obligations while ensuring accurate and timely billing, collections, and compliance with applicable regulations.

Requirements

• Associate degree in Business, Accounting, Healthcare Administration, Finance, or related field preferred.
• Minimum of two years of healthcare billing, patient accounts, insurance, financial counseling, or business office experience preferred.
• Experience in long-term care, skilled nursing, or healthcare reimbursement strongly preferred.
• Working knowledge of Medicare, Medicaid, managed care, and insurance billing practices preferred.
• Equivalent combination of education and experience may be considered.
• Medical Terminology preferred.
• Must possess working knowledge of CPT/ICD-10 coding, insurance practice and billing software.

Responsibilities

• Resident Financial Counseling: Meet with prospective residents, residents, and family members to explain financial obligations and payment options. Provide guidance regarding Medicare, Medicaid, long-term care insurance, managed care plans, and private-pay responsibilities. Assist residents and families with Medicaid application processes and required documentation. Educate residents and responsible parties regarding billing statements, insurance benefits, and account balances. Maintain confidentiality of resident financial information in accordance with HIPAA and organizational policies.
• Billing and Account Management: Prepare and submit accurate resident billing for long-term care, skilled nursing, and ancillary services. Verify insurance coverage, eligibility, authorizations, and benefit limitations. Process Medicare, Medicaid, managed care, long-term care insurance, and private insurance claims. Monitor resident accounts receivable and follow up on outstanding balances. Investigate, resolve, and document billing discrepancies and claim denials. Maintain accurate resident financial records and supporting documentation. Generate and review billing reports, aging reports, and account reconciliations.
• Collections and Follow-Up: Contact residents, families, insurance companies, and responsible parties regarding unpaid balances. Establish payment plans in accordance with facility policies. Follow collection procedures while maintaining positive customer relationships. Document collection activities and account status updates.
• Compliance and Regulatory Responsibilities: Ensure billing practices comply with federal and state regulations, Medicare and Medicaid requirements, and facility policies. Maintain up-to-date knowledge of reimbursement regulations and payer requirements. Assist with audits and provide requested documentation. Support compliance efforts related to resident financial records and reimbursement activities.
• Collaboration: Work closely with Admissions, Social Services, Nursing, and Business Office staff to ensure accurate payer information. Communicate changes in resident payer status to appropriate departments. Participate in care conferences and admission meetings as needed to address financial matters. Performs other duties and responsibilities as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree