Managed Care Centralized Business Office Manager

CommuniCare Health Services is currently recruiting a Managed Care Team Lead / Centralized Billing Office Manager for our Central Billing Office in Linthicum Heights, MD.

PURPOSE/BELIEF STATEMENT

The Managed Care Centralized Billing Office Manager oversees the process of billing and collection for Insurance Primary claims. This includes ensuring claims are submitted accurately and timely per most recent payer guidelines and are followed up on timely based on payer trend, as well as ensuring cash is collected on all claims in a timely manner.

WHAT WE OFFER

As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.

QUALIFICATIONS/EXPERIENCE REQUIREMENTS

• Knowledge of Managed Care Insurance Primary Billing Guidelines and electronic claim submission
• Experienced in billing Medicare Advantage, Medicaid MCO’s, and Commercial Insurance Plans
• 1 - 2   years previous billing experience
• 2 - 4 years advanced education beyond high school, or comparable work experience
• Professional appearance and mannerisms
• Ability to work as part of a team
• Computer skills including, but not limited to Microsoft Word, Excel, and Outlook
• Knowledge of  Point Click Care and Quadax preferred

JOB RESPONSIBILITIES

• Manage the Managed Care Centralized Billing Office for skilled nursing facilities.
• Direct supervision and support for Managed Care A/R Billing Specialist positions that are responsible for billing and collection of Insurance Primary claims.
• Ensure claims are submitted accurately and timely per most recent payer guidelines and are followed up on timely based on payer trend and company policy.
• Provide continuing education to staff regarding payer regulation changes and trends.
• Maintain the Managed Care claims transmission software (Quadax)
• Manages issues related to electronic claim submissions to include interpreting various electronic reports.
• Maintain valid user id’s and access for Managed Care CBO team for Insurance portal access.
• Responsible for development and updates to Managed Care CBO related standard operating procedures.
• Responsible for working with management and other various CBO Director/Managers for development and updates to the complete revenue cycle.
• Review and process all Managed Care CBO patient account adjustments.
• Review and forward for processing all Managed Care CBO patient write offs.
• Responsible for managing monthly A/R Reviews with Managed Care CBO A/R Billing Specialists.
• Responsible for Cash Collections Reporting and explanations of cash shortages.
• Responsible for various other duties as assigned.

About Us

A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients and family members care for and about one another.