Business Services Supervisor -Skilled Nursing Facility

Mercy Harvard Hospital•Harvard, IL

3h•Hybrid

About The Position

Serves as a subject matter expert for all aspects of skilled nursing billing processes and the respective biller roles. Maintains advanced knowledge of payor updates, including Federal and State guidelines, department workflows, and resources needed to resolve payor rejections, billing errors, and troubleshoot identified denial trends to ensure a clean claim rate. Knowledgeable with billing software MatrixCare and Epic, and crossed trained in multiple billing sectors (Medicare, Medicaid, and Commercial) to assist in the Epic biller work queues as needed. Knowledge of verifying payor sources and state and federal nursing home guidelines. Tracks facility census information and sends census daily. Completes census, payer builds, and payer verification in MatrixCare. Reviews resident accounts and aging reports on an ongoing basis. Responsible for monthly Medicaid, Medicare, and other insurance billings, along with timely follow-up with intermediaries on delinquent payments in coordination with the outside billing company. Monitors and manages the accounts receivable collection process, pursuing past due accounts persistently and maintaining proper back-up documentation. Obtains and submits all required documentation to bill third-party payers as per program/company guidelines. Participates in the resident admission process by providing explanations of the facility's rates, billing cycle, and payment terms, including collecting the first month's advance payment upon admission. Performs all Month End duties to ensure revenue is booked and billed correctly and timely. Maintains personnel and resident files in accordance with all applicable laws and regulations. Develops and implements policies and procedures related to Skilled Nursing Facility patient access. Implements procedures related to our financial services policy and ensures proper workflows to meet revenue and reimbursement goals. Maintains the skilled nursing facility billing program, including charge master updates, fee schedule maintenance, user account maintenance, and census event registration maintenance. Completes and processes audit requests and follows up to ensure that payers receive needed information and that reimbursement is not affected. Supervises business office staff, conducts employee performance reviews with subsequent discussion of pertinent review findings and recommendations. Hires partners for Skilled Nursing Facility patient financial counseling, provides training, coaching, and disciplining employees, and resolves employee issues. Provides a primary point of contact for customer inquiries and works with patients and other customers face-to-face or by phone. Provides excellent customer service and ensures that employees provide the same positive and helpful image. Uses problem-solving skills to identify and correct problems before they escalate to larger issues. Collaborates and communicates with other departments to ensure positive interdepartmental interactions. Assists with the follow-up on patient billing complaints received. Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies.

Requirements

Associate’s degree in accounting, business management, bachelor’s degree preferred.
Experience of Business Office Management of at least 2 years.
Strong multitasking, communication, organizational, and interpersonal skills are critical for a successful career as a business office manager.
Experience with MatrixCare software is preferred.
Minimum two years’ experience in a healthcare environment including supervisory and/or training experience.
Knowledge of reimbursement practices for commercial and government payers.
Passing the Driver’s License Check and/or Credit Check (for those positions requiring).
Passing the WI Caregiver Background Check and/or IL Health Care Workers Background Check.
Must be able to follow written/oral instructions.
Mathematical Skills - Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Language Skills - Excellent oral and organizational skills.
Ability to read, analyze, and interpret general business periodicals and technical manuals.
Ability to effectively present information and respond to questions from managers and other departmental personnel.
Reasoning Ability - Strong problem solving skills.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
Ability to deal with problems involving several concrete variables in standardized situations.
Computer Skills - To perform this job successfully, an individual should be familiar Windows based computer systems.
Additional knowledge of automated accounting systems, Plus, Star, and Kronos.
Must be able to read, write and speak English.

Nice To Haves

Bachelor’s degree preferred.
Experience with MatrixCare software is preferred.

Responsibilities

Serves as a subject matter expert with regards to all aspects of skilled nursing billing processes and the respective biller roles.
Maintaining an advanced knowledge of payor updates including Federal and State guidelines, department workflows and resources needed to resolve payor rejections, billing errors and troubleshoot identified denial trends to ensure clean claim rate.
Knowledgeable with billing software MatrixCare and Epic crossed trained in multiple billing sectors (Medicare, Medicaid and Commercial ) to assist in the Epic biller work queues as needed.
Knowledge of verifying payor sources.
Knowledge of state and federal nursing home guidelines.
Track facility census information, send census on daily basis.
Complete census, payer builds and payer verification in MatrixCare.
Review resident accounts and aging reports on ongoing basis.
Responsible for monthly Medicaid, Medicare, and other insurance billings along with timely follow-up with intermediaries on delinquent payments in coordination with outside billing company.
Monitor and manage the accounts receivable collection process.
Pursue past due accounts persistently and maintain proper back-up documentation.
Obtain and submit all required documentation to bill third party payers as per program/company guidelines.
Participate in the resident admission process by providing explanations of the facility's rates, billing cycle and payment terms, including collecting the first month's advance payment upon admission.
Perform all Month End duties to ensure revenue is booked and billed correctly and timely.
Maintains personnel and resident files in accordance with all applicable laws and regulations.
Develops and implements policies and procedures related to Skilled Nursing Facility patient access.
Implement procedures related to our financial services policy and ensure proper workflows to meet revenue and reimbursement goals.
Maintain the skilled nursing facility billing program including charge master updates, fee schedule maintenance, user account maintenance, and census event registration maintenance.
Complete and process audit requests and follow up to ensure that payers receive information needed and that reimbursement is not affected.
Supervises business office staff.
Conduct employee Performance Reviews with subsequent discussion of pertinent review findings and recommendations.
Hires partners for Skilled Nursing Facility patient financial counseling, provide training, coaching and disciplining employees; and resolve employee issues.
Provide a primary point of contact for customer inquiries and work with patients and other customers face to face or by phone.
Providing excellent customer service and ensure that employees provide the same positive and helpful image.
Uses problem solving skills to identify and correct problems before they escalate to larger issues.
Collaborate and communicate with other departments to ensure positive interdepartmental interactions.
Assist with the follow up on patient billing complaints received.
Maintains professional and technical knowledge by attending educational workshops; review professional publications; establish personal networks and participate in professional societies.
Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems; employee adherence to annual education and certification requirements.