Responsible for verifying skilled nursing patient set up in PointClickCare (PCC), billing, and follow-up of skilled nursing Medicare, Managed Care, Medicaid, and coinsurance claims through clearing house, online portals, and via phone.
Perform quality assurance checks of patient information in PCC.
Bill initial and/or adjusted skilled nursing (SNF) claims for Managed Care, Medicare, Medicare copy claims, Benefit exhaust, no pays, Medicaid, and Coinsurance through Waystar clearing house, fax, or online portals. Billing SNF Private Pay statements thorough Waystar.
Create and bill carve out and high cost drug claims.
Performa revenue input, claim creation, billing, and follow-up of immunization charges to Medicare and Manage Care.
Maintain familiarity with current and past contracts with Managed Care companies.
Follow up on past due revenue for Medicare, Managed Care, Coinsurance, and Medicaid accounts. Maintain knowledge of past due revenue for monthly calls with communities and Finance Director.
Support communities with PCC, Medicare/Insurance, contract, and patient account questions that may arise.
Follow up on all SNF credit accounts to determine if refund or escheatment is due or PCC adjustment is needed.
Process write off and refunds via Service Now and PCC.
Perform month end closing of divested communities in PCC.
Track all claims for monthly billing deadlines.
Provides support for other team members as needed.

High school diploma or general education degree (GED) and minimum of one to three years related experience
Additional education may be substituted for years of experience requirement on a year-for-year basis up to 2 years
Associate’s or Bachelor’s Degree preferred
Prior experience billing Medicare and insurance claims is required
Must have proficiency in Microsoft office including Excel and Word
Prior experience with PCC and Waystar, and experience in SNF billing is preferred.

Medical, Dental, Vision insurance
401(k)
Associate assistance program
Employee discounts
Referral program
Early access to earned wages for hourly associates (outside of CA)
Optional voluntary benefits including ID theft protection and pet insurance
Paid Time Off
Paid holidays
Company provided life insurance
Adoption benefit
Disability (short and long term)
Flexible Spending Accounts
Health Savings Account
Optional life and dependent life insurance
Optional voluntary benefits including accident, critical illness and hospital indemnity Insurance, and legal plan
Tuition reimbursement

Patient Account Representative

About this role