Senior Resident Account Specialst bei None

Position Summary:  

The Senior Resident Billing Specialist position reports directly to the Director of Revenue Cycle Management and will assist in the resident billing and revenue collection function for the St. John’s Senior Services and its affiliates.

Qualifications & Education Required:

• Associates Degree with five  (5) to seven (7) years of billing and computer experience
• Knowledge of medical billing with five (5) years minimum experience in a healthcare facility, healthcare business office, physician's office, or insurance billing environment.
• Certified Medical Biller experience preferred or must be willing to obtain Medical Billing certification within one year of employment
• Must maintain active Medical Billing certification while employed with St. John’s, which includes completion of required continuing education credits.
• Knowledge of LTC/Skilled Nursing third party billing preferred
• Ability to interact with elders and care for their needs
• Willingness to embrace and exemplify St. John’s Brand Characteristics

Core Organizational Competencies:

• St. John’s Brand Characteristics - Embrace living by being Friendly, Respectful, Responsive, Compassionate, Innovative and Fun towards elders, families and colleagues.  
• Teamwork - Actively participates. Assists team members; offers encouragement. Acknowledges/welcomes elders. Keeps team members informed. Recognizes achievements and efforts of others. 
• Job Knowledge - Consistently demonstrates working knowledge of all aspects of job. Remains current on job related changes and trends.
• Planning/Organization - Demonstrates initiative; plans appropriately. Uses time, materials, resources effectively. Organizes work to ensure commitment and priorities.
• Productivity - Consistently maintains high activity and efficiently produces acceptable volume of work. Consistently meets deadlines and commitments.
• Quality - Consistently produces accurate, timely work which meets required quality standards. Pays attention to detail. Sets high standards of performance for self and actively seeks continuous improvement. Provides elder-driven care.
• Reliability - Consistently delivers on commitments. Can be counted on to accomplish tasks without follow up. Available when required by elder or team and can be counted on to help or assist when needed. Responds in a timely manner.
• Demeanor (attitude) - Embraces change with optimism. Addresses concerns appropriately. Positively communicates. Good listener. Consistently maintains a positive demeanor.

Position Competencies:

• Technical expertise in managing a patient billing and accounting department within a complex health care facility
• Data processing and billing systems as they relate to health service financial and billing
• Principles of patient relations and customer service
• Principles and practices of continuous quality improvement
• Federal, State, and County laws, codes, rules and regulations relating to Health Services fiscal and service delivery operations, including patient medical records, confidentiality, protected patient health care information, billing, and revenue collections
• New York State Medicaid and Medicare rules and regulations
• Basic methods and procedures of financial and statistical record keeping
• Standard accounting procedures in relation to billing, collections, and the resident revenue cycle management
• Federal, State, and private health insurance programs, billing, eligibility standards, and coding
• Principles and practices of conducting and responding to internal and external fiscal audits related to resident accounts receivable management
• Interpersonal skills:  support emotional, physical and social well-being of elders and Core Team
• Problem solving / decision making
• Leadership skills: provide consultation services to support elders and Core Team as needed, lead by example, distribute responsibilities among interdisciplinary team members
• Coaching and development: set clear expectations, coach Core Team, manage performance
• Organizational skills: talent management (oversee staffing, hiring, performance improvement),

Position Responsibilities:

• Meets with Elders and Residents to discuss viable assets associated with paying privately.
• Prepares and submits billing claims for Private, Medicare, Medicaid and other third-party insurances
• Maintain Clearinghouse and/or Electronic Medical Record as needed for all eligibility and billing needs
• Meet all required billing and department deadlines
• Ensure proper procedures related to Medicare, Medicaid and other third-party payers
• Proactively work monthly aging accounts receivable reports and follow up on unpaid payer type balances including but not limited to performing various collection actions including contacting responsible parties by phone and sending past due notices;
• Regularly meet with supervisor to discuss and resolve reimbursement issues or billing obstacles;
• Meets with Elders and Residents to discuss Medicaid Application Process, Recertifications, Rep Payee, and Social Security Reports
• Works with Medicaid application vendor to oversee the process to prepare and submit Medicaid Applications, including timely follow up on application status;
• Assists in drafting and implementing new and revised policies and procedures for resident financial services, resident accounting, billing, and the revenue cycle management
• Provides analysis and suggestions to management related to revenue cycle enhancements
• Works with front-line technical support staff in maintaining the operations of resident accounting systems
• Works directly with external auditors to assist in responding to regulatory audits
• Provides and promotes excellence in customer service for both internal and external customers
• Help with other duties as needed that support the Core Team to fulfill St John’s mission vision and values

Physical Requirements:

• While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear.  The employee frequently is required to reach with hands and arms.  The employee is occasionally required to stand; walk; climb or balance; and stoop, kneel, crouch, or crawl.  Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus

Exposure to Conditions:

• The conditions described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Employee may be exposed to indoor temperature fluctuations. The noise level in the work environment is usually quiet. Required to attend mandatory meetings and/or trainings. This is an on-site position.