Description

UPMC Senior Communities is now looking to hire a Full-time, Hybrid Business Office Manager! 

Functioning within the UPMC Senior Communities central billing office and reporting to the Manager, Patient Accounts, this position is responsible for coordinating all aspects of the revenue cycle for skilled nursing and long-term care facilities, including the performance of month-end closing activities, patient billing and collections, cash receipt posting, and ensuring efficient daily operations of the business office for assigned areas of responsibility.

Responsibilities:

• Complete the monthly accounts receivable close process for assigned areas of responsibility in accordance with established deadlines, including reconciliation of monthly census, posting of cash receipts, and the input/import of all patient charges.
• Ensure the integrity of the accounts receivable close process through appropriate reconciliation procedures and follow up on any noted revenue discrepancies.
• Ensure the timely submission of all patient claims, including secondary claims, to third-party insurers, including but not limited to Medicare, Medicaid, and various managed care organizations.
• Collaborate with facility clinical staff to ensure the accuracy of coding on claims prior to submission.
• Perform appropriate follow-up on submitted claims to ensure timely collections, maintain healthy facility cash flows, and minimize patient accounts receivable.
• Work with appropriate third-party agencies including payors, collection agencies, legal counsel, etc., to resolve difficult collections matters.
• Perform account audits and process appropriate adjustments within the billing system. If collection efforts become exhausted, complete bad debt write-off forms and submit to supervisor for approval.
• Participate in regular accounts receivable meetings with management and facility staff to define collection strategies and maintain open communication regarding problem accounts.
• Facilitate strong two-way communications between the central billing office and facility-based business office staff to promote efficient work flow.
• Provide guidance and support to facility-based business office staff as necessary.
• Serve as back-up to facility-based business office staff.
• Assist with the Medical Assistance application process as necessary.
• Assist in development, revision, and implementation of policies and procedures for accounts receivable (including the admissions process) in the skilled nursing facilities, with the goal of promoting consistency in operations.
• Audit vendor invoices for transportation, lab, and radiology to ensure accuracy of charges and payor data. Ensure timely submission of vendor invoices for payment.
• Maintain Resident Trust Fund to ensure timely payment of resident's AR accounts and payment of resident?s personal expenses
• Participates in and provides relevant data for all external and internal audits (UMR reviews, year-end financial audits, etc.).
• Works with the finance department to provide relevant accounts receivable information required for the annual Medicare and Medicaid cost reports.
• Adhere to the UPMC Health System Standndards of Conduct and all applicable laws and regulations.
• Maintain both yourself and your work area in a professional manner at all times.
• Perform other duties in support of the central billing office and facilities as assigned by supervisor.
• Business Office Managers that are not based out of the central billing office may have additional responsibilities associated with private pay billing and collections, management of the Medicaid pending caseload, and management of the daily activities of the facility business office.

Qualifications

• Bachelor's degree
• OR High school diploma or equivalent with 2 years of billing experience in a skilled nursing facility
• OR High school diploma or equivalent with 5 years of general healthcare billing experience
• Strong preference for prior experience in a skilled nursing facility (SNF) business office with knowledge of Medicare, Medicaid, and third-party billing regulations.
• Must have strong organizational and computer skills.

UPMC is an Equal Opportunity Employer/Disability/Veteran

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