REGIONAL ACCOUNTS RECEIVABLE

Job Description

Job Description

Come join this collaborative and innovative team. At Integritus Healthcare, you will enjoy WEEKLY pay, generous time off, exceptional health insurance, and the ability to grow in your career.

Ready to love working again and be proud of where you work? Do you want to be valued and have an opportunity to make a meaningful impact? If you answered ‘yes,’ we can’t wait to introduce you to our team of dedicated, caring professionals.

Join one of the largest post-acute health care systems across Massachusetts, committed to fulfilling the health and residential needs of the population in the communities we serve.

Why Integritus Healthcare:

• Competitive Compensation
• Employee Satisfaction
• Growth and Career Advancement
• Cookouts and Luncheon’s
• Culture of Respect and Empowerment

• Celebrating Individuality
• Recognizing Excellence

Benefits include but not limited to:  

• Paid time off (vacation, sick, holiday)
• Medical Insurance
• FSA
• Dental
• Vision
• Life Insurance
• Long-term disability Insurance
• HRA
• 401(k)

Essential Administrative Job Functions  

• Lead for Wellsky non-clinical system operation and claim error resolution.
• Annual Hospice reimbursement rate update communication with contracted facilities.
• Responsible for maintaining confidentiality of patient information.
• Review and edit generated home health, hospice and palliative care claims for accuracy, errors or discrepancies, prior to submission for payment
• Review and edit home health, hospice and palliative care claim for correct coding as required.
• Resolve home health, hospice and palliative care claim errors and warnings, prior to submission for payment
• Review and revise home health, hospice and palliative care claims, "returned to provider" and "rejected" by payer source and re-submit to billers for re-submission to payer source
• Review home health, hospice and palliative care claims that have been denied and determine appropriate appeal/adjustment/action needed to re-submit for payment
• Track and submit OASIS assessment to iQies portal and communicate any corrections to Home Health Branch Manager
• Enter new payers and coinciding rates for home health, hospice or palliative care
• Review fee schedules for home health, hospice and palliative care and as necessary adjust/update contractual rates in EHR
• Provide final verification of home health, hospice and palliative care patient insurance coverage prior to claim submission
• Resolution of Notice of Election denials for Medicare Hospice patients
• Resolution of Notice of Admission denials for Medicare Home Health patients
• Verify appropriate updates/changes to facility room and board rates for hospice patients, including patient pay amounts, to ensure proper MassHealth claim generation prior to submission
• Communicates effectively with patients, families, vendors and staff.
• Responsible for assisting with audits as necessary.
• Input and/or correction of data into EHR for billing purposes
• Other duties as assigned by the Executive Director(s), Branch Manager and/or Management Team.

Qualifications  

(Minimum qualifications will be considered required unless specifically stated otherwise)  

Experience:   

• Minimum of two (2) years of experience in a health care setting, hospice and/or volunteer experience preferred.

Education and Training:

(Acquired through formal education, outside study, training on jobs of lesser degree, or by any combination of these. May be expressed in terms of formal educational equivalents):    

• College degree in a related field preferred. High School education required.

License, Certification & Registration:  

• Valid driver’s license

Other Requirements:  

• Demonstrates excellent written and oral communication skills and public relations skills.
• Excellent computer skills.
• Ability to collaborate to resolve EHR/Billing issues within regulatory and system operational confines.
• Ability to organize and develop processes to meet organizational revenue collection needs.

Working Conditions  

• Uniform / Dress Requirements (Beyond those requirements outlined within Policy No. C:3-015.1):None

Work Environment:  

• Working Conditions: Office environment. Subject to varying and unpredictable situations.  Handles emergency or crisis situations. 
• OSHA exposure category: Category III
  • Category I ― Position includes tasks that involve exposure to blood, body fluids, tissues.
  • Category II ―Position includes tasks that involve no exposure to blood, body fluids, tissues, but employment may require unplanned Category I tasks.
  • Category III ― Position includes tasks that involve no exposure to blood, body fluids, tissues; would not be required to perform Category I tasks.

Physical Demands: (See Attached)

The above statements are intended to describe the general nature and level of work being performed by employees within this classification. They are not intended to be construed as an exhaustive list of all duties and responsibilities.