Job Details

CommuniCare Corporate -

WV Medicaid Biller

CommuniCare Health Services is currently recruiting a Medicaid Biller for our Central Billing Office located in Charleston, WV. This position will report locally to our Stonerise Regional Office located 700 Chappell Rd,Charleston, WV 25304.

Estimated Pay: Pay is negotiable based on experience.

Schedule: Full Time, 8a-4:30p

PURPOSE/BELIEF STATEMENT

The position of Medicaid Biller is responsible for billing, receivables auditing, and collections activities for services provided to patients in the facilities assigned.

WHAT WE OFFER

All CommuniCare employees enjoy competitive wages and PTO (Paid Time Off) plans. We offer full time employees a menu of benefit options that include:

• Life Insurance and Disability Plans
• Medical, dental, and vision coverage from quality benefit carriers
• 401K
• 6 paid Holidays and 1 floating Holiday.

QUALIFICATIONS/EXPERIENCE REQUIREMENTS

• High School graduate or GED required.
• 5+ years' experience with WV Medicaid
• Knowledge of PCC
• Prior work/life experience, preferably in a long-term care setting.
• Prior work/life experiences, preferably in a healthcare setting.
• Prior experience preferably with related software applications.

KNOWLEDGE/SKILLS/ABILITIES

• Knowledge of medical billing/collection practices.
• Must be knowledgeable of accounts receivable practices and procedures, as well as laws, regulations and guidelines that pertain to long term care.
• Must have a high degree of attention to detail.
• Must have the ability to make independent decisions when circumstances warrant such action, sense of urgency.
• Strong mathematical, written and verbal communication skills.
• Basic computer literacy and skills
• Strong organizational skills a must.

JOB DUTIES AND RESPONSIBILITIES

• Ensure all claims have been submitted and exported correctly according to each payer's Billing Procedure.
• Follow up on unpaid claims within the standard billing cycle time frame.
• Post all payments received against the appropriate claim.
• Check each insurance payment for accuracy and compliance with contract discount.
• Prepare necessary adjustments, enter into billing system, and provide backup documentation to Supervisor.
• Research, resolve, resubmit, and/or appeal all denied claims in a timely manner.
• Prepare appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany appeal.
• Maintain Medicaid bad-debt log by tracking billings, monitoring collections, compiling information
• Review and audit A/R aging reports as necessary.
• Write thorough collection notes on billing activity with clear and reliable data.
• Prepare Weekly/Monthly Reports as instructed by the CBO Team Manager.
• Maintain work operations by following policies and procedures, reporting compliance issues.
• Maintain quality results by following standards.
• Other duties as assigned

About Us

A family-owned company, we have grown to become one of the nation's largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients, and family members care for and about one another.