Accounts Receivable Clerk
On-siteLexington, Kentucky, United States
Job Summary
Manage resident accounts receivable for Medicare, Medicaid, managed care, hospice, VA, and private-pay within a skilled nursing facility. Prepare and submit claims, post payments and adjustments, and resolve billing discrepancies or denials. Monitor aging reports to follow up on outstanding balances and coordinate with Admissions to ensure accurate payer information. Assist residents and families with billing questions and support Medicaid application processes. Maintain complete documentation, prepare monthly reports, and participate in audits while ensuring compliance with CMS and HIPAA regulations. Work Monday through Friday, 40 hours per week.
Required Qualifications
- Experience with Medicare, Medicaid, managed care, hospice, VA, and private-pay billing
- Knowledge of federal and state regulations
- Knowledge of payer requirements
- Knowledge of facility policies
- Ability to prepare and submit claims for Medicare Part A, Medicaid, managed care organizations, hospice, private pay, and other third-party payers
- Ability to monitor resident accounts for timely payment and appropriate reimbursement
- Ability to post payments, contractual adjustments, denials, refunds, and account corrections
- Ability to review accounts receivable aging reports and follow up on outstanding balances
- Ability to research and resolve billing discrepancies, claim rejections, payment delays, and denials
- Ability to work with insurance companies, Medicaid agencies, managed care organizations, and responsible parties to resolve payment issues
- Ability to maintain complete documentation supporting all billing and collection activities
- Ability to coordinate with Admissions to ensure payer sources, authorizations, and resident demographic information are accurate
- Ability to assist residents and family members with billing questions, account balances, payment options, and financial responsibilities
- Ability to support Medicaid application and pending processes
- Ability to verify insurance coverage, benefits, authorizations, and eligibility
- Ability to prepare monthly accounts receivable reports and assist with month-end close activities
- Knowledge of CMS regulations
- Knowledge of HIPAA
- Knowledge of Medicare and Medicaid billing guidelines
- Ability to participate in audits by providing requested documentation and resolving audit findings
- Ability to communicate effectively with interdisciplinary team members to resolve reimbursement issues
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