AR Collections Specialist - Full-Time
Company: Diakonos Group
Posted on: February 8, 2020
We are driven by our commitment to our industry and expect
excellence from our employees. We build a work environment where
each individual is valued and has the opportunity for growth.:We
strive to be the guiding light in our profession.:Purpose of Your
Job PositionThe primary purpose of your job position is to assist
in collections of payments from all payers, including, but not
limited to, Managed Care, Co-Insurance and Medicaid. Manage and
assist the Medicaid Billing Specialist and Business Services
Associates with the Medicaid Pending Process, from application,
estimating vendor pay and approval processes for all Medicaid
billing locations that include skilled nursing facilities and
applicable assisted living faciliJob FunctionsEvery effort has been
made to identify the essential functions of this position. However,
it in no way states or implies that these are the only duties you
will be required to perform. The omission of specific statements of
duties does not exclude them from the position if the work is
similar, related, or is an essential function of the
position.DUTIES AND RESPONSIBILITIESEssential Functions
- Audit and correct all accounts where payment does not equal the
revenue booked, resulting in a debit or credit balance for
Medicaid, Managed Care and Co-insurance payers.
- Upload or assist in sending documentation to payers on audit
requests after the documentation is gathered by our Medicare Nurse
- Assist Medicare Nurse Consultant in auditing PCC to make sure
correct documentation is in our system to support billing and send
those results to the facilities to correct.
- Responsible for adding billing notes regarding status of unpaid
- Ensure documentation of all actions relating to a specific
case. Assure all records are up-to-date and reflect current
activity on a daily basis.
- Collect ancillary bills from facilities monthly and upload it
to the shared drive.
- Responsible for maintaining current knowledge of regulations,
industry trends, current practices, and new developments regarding
credit issues and the long term care industry.
- Ensure knowledgeable in Medicare, Managed Care, Medicaid,
benefit coordination, payor requirements on submitting claims, and
techniques in how to submit a clean claim to ensure payment at
- Understand factors affecting DSO and Bad Debt e.g. Payor Source
Sequencing, Coordination of Benefits, Insurance Requirements, and
Appeals/Denials.Safety and Sanitation
- Report all unsafe/hazardous conditions, defective equipment,
etc., to your supervisor immediately.
- Follow all established safety procedures and precautions when
operating office equipment.Equipment and Supply Functions
- Ensure nursing supervisory supplies have been replenished in
work areas as necessary. Report equipment/supply needs to your
- Ensure that work/assignment areas are clean and equipment and
supplies are properly stored before leaving such areas on breaks,
end of day, etc.Budget and Planning Functions
- Report suspected or known incidence of fraud relative to false
billings, cost reports, kickbacks, etc.Resident Rights
- Maintain the confidentiality of all resident care information
including protected health information. Report known or suspected
incidents of unauthorized disclosure of such information.
- Ensure that residents rights to fair and equitable treatment,
self-determination, individuality, privacy, property, and civil
rights, including the right to wage complaints are followed.
- Knock before entering a residents room.Other Duties
- Please note this job description is not designed to cover or
contain a comprehensive listing of activities, duties or
responsibilities that are required of the employee for this job.
Duties, responsibilities, and activities may change at any time
with or without notice.Working Conditions
- Works throughout the assigned area (i.e., offices, facilities,
- Moves intermittently during working hours.
- Is subject to frequent interruptions.
- Is involved with residents, personnel, visitors, government
agencies/personnel, etc., under all conditions and
- Is subject to hostile and emotionally upset residents, family
members, personnel, and visitors.
- Communicates with facility personnel and support team
- Works beyond normal working hours, on weekends and holidays,
and in other positions temporarily, when necessary.
- Is subject to call back during emergency conditions (e.g.,
severe weather, evacuation, post-disaster, etc.).
- Attends and participates in continuing educational
- Is subject to injury from falls, burns from equipment, odors,
etc., throughout the workday, as well as to reactions from dust,
disinfectants, tobacco smoke, and other air contaminants.
- Is subject to exposure to infectious waste, diseases,
conditions, etc., including TB and the AIDS and Hepatitis B
- May be subject to the handling of and exposure to hazardous
chemicals.EducationMust possess, as a minimum, a high school
education or its equivalent. Associates Degree preferred but not
required.Salary is contingent on experienceExperience
- Minimum of two years billing experience in a LTC/SNF
environment or in a Central Billing Office for LTC Company is
- Working knowledge of Oklahoma Medicaid Programs as they operate
in SNF environment
- Working knowledge of Medicare, Managed Care and Co-Insurance in
a SNF environment.
- Experience using Word, Excel. Experience using PCC is helpful,
but not required.Specific Requirements
- Must be able to read, write, speak, and understand the English
- Must be proficient in Word and Excel.
- Point Click Care Experience is helpful, but, not required.
- Must have clear written and verbal communication skills.
- Must be able to maintain confidential information.
- Most possess good time management skills.
- Must maintain excellent attention to detail.
- Must be a supportive team member, contribute to and be an
example of team work and team concept.
- Must possess the ability to make independent decisions when
circumstances warrant such action.
- Must possess the ability to deal tactfully with personnel,
residents, family members, visitors, government agencies/personnel,
and the public.
- Must possess the ability and willingness to work harmoniously
with other personnel.
- Must have patience, tact, a cheerful disposition and
enthusiasm, as well as the willingness to handle difficult
- Must not pose a direct threat to the health and safety of other
individuals in the workplace.
- Must be able to work independently.Physical and Sensory
Requirements(With or Without the Aid of Mechanical Devices)
- Must be able to move intermittently throughout the
- Must be able to speak and write the English language in an
- Must be able to cope with the mental and emotional stress of
- Must be able to see and hear or use prosthetics that will
enable these senses to function adequately to ensure that the
requirements of this position can be fully met.
- Must function independently and have flexibility, personal
integrity, and the ability to work effectively with residents,
personnel, and support agencies.
- Must meet the general health requirements set forth by the
policies of this facility, which include a medical and physical
- Must be able to relate to and work with the ill, disabled,
elderly, emotionally upset, and, at times, hostile people within
- Must be able to push, pull, move, and/or lift a minimum of 25
pounds to a minimum height of 5 feet and be able to push, pull,
move, and/or carry such weight a minimum distance of 50 feet.
- May be necessary to assist in the evacuation of residents
Keywords: Diakonos Group, Edmond , AR Collections Specialist - Full-Time, Accounting, Auditing , Edmond, Oklahoma
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