Billing Reimbursement Specialist

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Maintain and update the daily census records to ensure accuracy in resident tracking and billing.
• Verify insurance benefits and eligibility for Skilled Nursing Facility (SNF) residents before or during admission.
• Communicate insurance coverage details to residents and/or responsible parties in a clear and timely manner.
• Review, prepare, and distribute private pay statements to residents or responsible parties.
• Perform follow-up and collection activities on outstanding private pay balances.
• Submit co-insurance claims to appropriate payers following established billing procedures.
• Conduct follow-up and collection on outstanding co-insurance balances to ensure timely reimbursement.
• Collect and post payments for miscellaneous charges and services not covered by insurance.
• Apply payments from insurance and private pay sources accurately and reconcile them to the cash receipts ledger.
• Respond to billing inquiries and written correspondence with appropriate documentation and professionalism.

QUALIFICATIONS

• One year certificate from college or technical school; or three to six months related experience and/or training; or equivalent combination of education and experience.
• Minimum 2-5 years of experience.
• Language skills: Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the public. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.