Billing Specialist-PV

Pleasant View Billing Specialist

The Pleasant View Billing Specialist is responsible for providing support to the Pleasant View Nursing Home Residents and Administration by maintaining provider credentialing, coordinating client intake, billing appropriate insurances and Medicaid and Medicare programs, as well as preparing client statements. This position will monitor the status of all resident accounts, outstanding claims / invoices, write-offs, and report this information to Agency Leadership on a regular basis. The Billing Specialist is responsible for supplying the reporting data to the State of Wisconsin and / or Centers for Medicaid & Medicare as required.

Essential duties and responsibilities include the following : The following duties are normal for this position. These are not to be construed as exclusive or inclusive. Other duties may be required as assigned.

• Process resident paperwork for intake including financial information and determining eligibility
• Responsible for all functions of billing and coding processes for a skilled nursing facility (SNF)
• Manage accounts receivable billing and collection of payments for all forms of resident payments
• Prepare and mail resident statements monthly
• Monitor accounts receivable and involve Office Manager or Administrator as necessary
• Respond to account questions and billing discrepancies
• Maintain resident account balances and transaction history.
• Update rates in Point Click Care annually to match the approved fees.
• Prepare deposits and post payments.
• Process Managed Care and Insurance weekly as well as submission updates.
• Provide Medical Reports and Documentation as requested by Managed Cares, Insurance and other billing entities
• Maintain confidentiality of all residents' information.
• Monitor and track account write-offs and report regularly to the Office Manager and Administrator
• Complete credentialing applications as needed to credential providers with insurance companies
• Maintain provider rosters for each insurance company
• Maintain and provide current credentialing lists for Nursing Home as needed
• Provides back-up to medical records secretary as needed
• Other duties as assigned

Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required.

Language Skills

Mathematical Skills

Reasoning Ability

Physical Demands

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Ability, in regard to environmental factors such as temperature variations, noise, disease, and / or dust, to work under moderately safe and comfortable conditions.

Green County is an equal opportunity employer.