Accounts Receivables for Long Term Care

2 weeks ago

Manila, National Capital Region, Philippines Callmax Solutions Full time
Key Responsibilities

Billing & Claims Management


• Prepare, review, and process billing for Medicare, Medicaid, Managed Care, private insurance, and private-pay residents.


• Verify resident eligibility, authorizations, and coverage changes in coordination with admissions and clinical teams.


• Ensure claims are submitted timely, accurately, and in compliance with federal, state, and payer-specific guidelines.


• Track all claim submissions, remittances, and denials.

Payments & Collections


• Post payments, adjustments, and write-offs accurately in the billing system.


• Maintain up-to-date aging reports and ensure timely follow-up on past-due accounts.


• Conduct outreach to payers, residents, and responsible parties to resolve outstanding balances.


• Monitor patient liability and NAMI (Net Available Monthly Income) requirements for Medicaid residents.

Reconciliation & Reporting


• Reconcile accounts receivable balances monthly and ensure accuracy across all payer types.


• Maintain logs for claims status, follow-up activities, and resolution timelines.


• Prepare and distribute weekly and monthly AR reports for facility and corporate leadership.


• Identify trends in denials, delays, or payment discrepancies and escalate issues accordingly.

Compliance & Documentation


• Maintain accurate and complete documentation for audits, surveys, and financial reviews.


• Ensure adherence to HIPAA and all LTC billing regulations.


• Collaborate with nursing, MDS, admissions, social services, and finance teams to maintain accurate billing data (admissions, discharges, payer changes, therapy minutes, etc.).

Qualifications


• Associate or Bachelor's degree in Accounting, Business, Healthcare Administration, or related field (preferred).


• Experience in long-term care billing or healthcare accounts receivable required.


• Knowledge of Medicare, Medicaid, Managed Care, and insurance billing guidelines.


• Familiarity with LTC billing software (e.g., PointClickCare, MatrixCare, ECS, ResMed Brightree, or similar).


• Strong understanding of UB-04 billing forms and remittance advice (EOB/EOMB).


• High accuracy in data entry and financial recordkeeping.

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