Billing Specialist

Resident Billing Specialist – Continuing Care Retirement Community

Edgewood Summit Inc.
300 Baker Lane
Charleston, WV 25302

Edgewood Summit is a pioneer and an innovator in the West Virginia Senior Living industry. As West Virginia’s first and only not for profit Continuing Care Retirement Community, Edgewood Summit provides attractive, caring, and comfortable living arrangements for its Residents. Since inception in 1995, Edgewood Summit has grown to provide 127 Independent Living Units, 40 Assisted Living Units, 20 Skilled Nursing Units, and 18 Memory Support Units as a place to call Home.

Job Qualifications:

Preference will be given to candidates who possess the following qualifications:

• High School Diploma or GED
• Relevant Bachelor’s Degree / Associate Degree
• Relevant Professional Certifications
• Experience in Customer Service
• Experience with working with a Senior Population
• Experience in Health Care Administration
• Experience in Medical Billing & Coding
• Experience with and Knowledge of Medicare and Health Insurance Providers
• Experience in Finance & Accounting
• Determined, Persistent, and Self-Motivated

Job Description:

The Resident Billing Specialist is responsible for preparing Resident Private Pay and Third-Party account invoices on a monthly basis and will monitor outstanding balance to ensure each account is paid on time and in full. The person in this role will possess a knowledge of accounting and ability to manage incoming payments, outgoing invoices, various reporting updates, and other day-to-day tasks. The person in this role will have excellent communication skills and be available to meet with Residents to discuss their account balance and assist with concerns.

Responsibilities:

• Maintain an updated and accurate Resident Census for Independent Living (IL), Assisted Living (AL), Skilled Nursing (SN), and Memory Support (MS).
• Maintain accurate revenue cycle records and procedures.
• Accurately record payments received from Insurance Providers and Private Pay Residents while maintaining current records and balances.
• Work closely with Edgewood Summit personnel to generate complete and accurate Resident account invoices and to review invoices for any errors or irregularities.
• Verify Medicare/Insurance eligibility and coverage days available and process claims timely.
• Review and Resubmit any Past Due balances and communicate with appropriate Medicare/Insurance personnel or private pay Resident to ensure any balance due is collected timely.
• Consult with Resident (and/or representative) to arrange a payment method.
• Consult with Residents (and/or representative) to assist them with understanding their invoice and charges.
• Maintain updated Resident profile and financial data, billing documents, reports, invoices, and other relevant documentation.
• Cooperates with fiscal intermediaries, accountants, auditors, cost report preparers, governmental agencies, and private insurance companies.
• Maintains good communication and relationships with other Edgewood Summit departments, Residents, Resident representatives, vendors, other staff, and visitors.
• Considerate of privacy and confidentiality and maintains compliance with HIPPA regulations.
• Works closely with Health Care Administrator and Business Office Manager to accomplish organizational goals.
• Performs other duties and tasks as assigned by Health Care Administrator and Business Office Manager.

Skills:

• Exceptional customer service skills, including conversation, patience, and empathy.
• Ability to maintain positive relationships with coworkers and residents.
• Comply with Edgewood Summit work schedule and attendance policy.
• Strong communication, including written, speaking, and active listening.
• Problem-solving and critical thinking skills.
• Knowledge of industry and best practices.
• Basic math, bookkeeping, and accounting knowledge.
• Organization, time management, and ability to prioritize.
• Ability to maintain security of Resident information and comply with HIPPA regulations.
• Advanced computer skills related to bookkeeping, accounting, and resident billing software.

Supervisory Responsibilities:

• This position has no supervisory responsibilities.

Reports to:

• Business Office Manager (Administrative Department)

Computer Skills:

• Experience with advanced computer software.
• Experience working with Microsoft office products.
• Experience with billing module software.

Job Types: Full Time – In Person

Schedule: The person filling this position will be expected to work Full-Time during normal Business Office Hours.

Location: Charleston, West Virginia (One Location)

Setting: Senior Living Facility, Administrative Office