Billing & Eligibility Specialist

What makes our care community different? People like you. Join our team as a Billing & Eligibility Specialist and don’t just start a job. Start a career. One that is meaningful and that gives you the opportunity to learn and grow. This would be a full-time Monday-Friday position.

[Responsibilities]

• Daily audit of admission, discharge and other source documentation to ensure revenue is recognized appropriately and all conditions of payment are met.
• Verify patient eligibility and payor coverage guidelines to ensure that all necessary information is secured for timely, accurate revenue recognition
• Assists patients in understanding financial obligations; collects co-payments, self-pay deposits, and patient balances to reduce Accounts Receivable.
• Weekly communication with site leadership detailing outstanding documentation or other issues resulting in a potential loss of revenue.
• Prepares invoices for reimbursement and performs follow up to ensure accurate, timely payments are made to our facility partners
• Prepare, submit and follow up on authorization and re-authorization requests according to applicable state and commercial payor guidelines.
• Coordinate, review, and analyze documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing
• Ensure all payer requirements are met accordingly, including pre-cert requirements, notification requirements, and level of care change required documents.
• Alerts appropriate team members at the Site regarding late or missing documents required for billing.
• Assure for compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures
• Meets with new admissions and/or responsible parties to establish relationships, gather financial information and obtain signatures on appropriate forms.
• Responsible for billing, insurance reimbursements and collections to ensure payment on all accounts
• Attends care conferences deemed necessary for payment/billing/collections
• Participates in discharge planning as it relates to billing/collections

[Minimum Required Qualifications]

• Minimum of one year of related healthcare billing experience
• High School Diploma or GED
• Ability to communicate verbally and in writing effectively
• Ability to follow all safety rules, regulations, policies and procedures of the facility including but not limited to: Vulnerable Adult and Abuse Policy, HIPAA, Resident’s Bill of Rights.

[ Preferred Qualifications]

• Healthcare financial experience
• Senior Care Experience
• Understanding of Medicare PDPM
• Associates Degree or higher

[Benefits]

• Take paid time off. Whether you work full-time or part-time
• Get paid more when you work weekends, evenings or overnights. We offer a $1/hour shift & weekend differentials.
• Earn money with our 401k company match.
• Receive full benefits including medical, dental and vision insurance. Medical insurance is offered to full-time team members working 30+ hours a week. Life insurance and disability insurance for team members working 20+ hours a week.

The Lutheran Home: Belle Plaine is a 75-bed skilled nursing facility that comprises of a Transitional Care Unit (TCU), Long-Term Care (LTC) and memory care.

EOE/AA/Min/F/Vet/Disability

In an effort to comply with requirements regarding government record keeping, reporting, and other legal obligations which may apply, we invite you to complete an applicant data survey. Providing this information is STRICTLY VOLUNTARY. Copy this link https://www.tlha.org/applicant-voluntary-survey/ and after submitting your resume, open a new tab of your internet browser and paste the URL to be directed to the survey.

Job Type: Full-time

Pay: $23.65 - $28.14 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Nursing home

Experience:

• Medical billing: 1 year (Required)

Work Location: In person