Claims processor Jobs in Everett, WA

Business Office Manager

We are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, inclusive and supportive work environment where every team member is valued and empowered to make a difference. Whether you're an experienced professional or just starting your career, we offer opportunities for growth, development, and advancement in a range of roles. Join us in our mission to enhance the well-being of our patients and residents while making a meaningful impact in the communities we serve.

The Business Office Manager "BOM" must be familiar with company policies and procedures related to all areas of Revenue Cycle Management, which includes census, ancillaries, billing, adjustments, deposits, collections, Medicaid Pending and resident funds. The BOM must also have a working knowledge of accounts payable. The BOM oversees all business office functions and is responsible for ensuring policy and procedure compliance in all related areas. The BOM must strive to meet all RCM goals. This position regularly supervises 2 or more full time employees (or equivalent to 2 employees) within the center's business office/administration department which may include Assistant Bus. Office Manager, Bookkeepers, and Receptionists. The BOM regularly interfaces with the Center Executive Director and other department heads including admissions, clinical, social service, etc. Additionally, the BOM works closely with the Revenue Cycle Manager in their market for training and support and communicates regularly with the Centralized Billing Office (CBO). They also interface with responsible parties, attorneys and outside agencies on financial issues.

Responsibilities/Accountabilities:

• Manages, trains, organizes, evaluates and monitors business office staff, which may include but is not limited to Assistant Business Office Manager, Bookkeeper and Receptionists, as well as delegates administrative authority, responsibility and accountability to other office personnel as necessary and as applicable;
• Responsible to meet deadlines for approving timecards and requests for time off for direct reports in relation to center's payroll cycle;
• Ensures systems and controls are in place and adheres to all policy and procedures outlined in policy manuals and meets established daily, weekly and monthly deadlines;
• Follows RCM business processes and oversees timely and accurate completion of all business office functions in the areas of census, ancillaries, billing, adjustments, collections, write offs, refunds and deposits;
• Manages all Resident Trust Fund procedures and ensures strict compliance with all state and federal regulations as well as company policies and maintains confidential files;
• Meets with or directs office staff to conduct a 72-hour financial meeting with new admissions (resident and/or responsible party) to explain financial obligations and paperwork, reviews uploaded admission files and reports missing financial information to center team;
• Complies with and monitors staff compliance with segregation of duties for cash handling and posting;
• Meets with, or ensures that another staff member meets with, residents/responsible parties upon discharge to explain any remaining financial obligations;
• Monitors private spend down and timely conversions to Medicaid Pending; manages Medicaid Pending tracking and all related processes including county escalation to obtain approvals and use of outside attorney for Guardianship or assistance with uncooperative resident/family;
• Ensures private advance billing is completed according to scheduled date and deadline; manages all month end processes, including completion of data entry, review and correction of trial claims, census reconciliation and all other checklist tasks; ensures deadlines are met and month end close is completed by the established time on the third workday;
• Manages the center accounts receivable collection responsibilities for private pay following the collection timeline; manages collection of decentralized payers; ensures accurate census and billing information for the timely filing of third party claims;
• Strives to meet RCM goals which include bad debt expense, cash collections, private credit reduction and other goals as communicated by RCM leadership; analyzes bad debt expense results and develops action plans for improvement as applicable;
• Participates and/or coordinates routine Revenue Cycle Management Reviews and maintains collection notes in the PCC collection module for payers the center is responsible for; keeps Center Executive Director (CED) abreast of collection issues and requests escalation as needed; monitors collection notes on third party accounts; responds timely to CBO requests for assistance or information via the assigned activities in the collection module;
• Recommends and prepares accounts for outside agencies, attorneys, and write off as applicable;
• Attends center morning meetings, IDT/UM/UR meetings and other center or RCM required meetings and calls;
• Participates in all BOM training sessions, implements new processes with business office staff, follows the RCM calendar and reviews monthly RCM Newsletter;
• Prepares documentation for internal and external auditors; works with Revenue Cycle Manager to help resolve G/L variances;
• Puts customer service first: Ensures that residents and families receive the highest quality of service in a caring and compassionate atmosphere which recognizes the individuals' needs and rights;
• Performs other duties as assigned.

Qualifications:

• High school degree with a minimum of five years' experience in long term care billing and collection experience preferred.
• Additional coursework in accounting/finance is recommended.

Benefits:

• Variable compensation plans
• Tuition, Travel, and Wireless Service Discounts
• Employee Assistance Program to support mental health
• Employee Foundation to financially assist through unforeseen hardships
• Health, Dental, Vision, Company-paid life insurance, 401K, Paid Time Off
• Free 24/7 virtual health care provided by licensed doctors for all Anthem medically-enrolled employees and their immediate family members
• On-Demand Pay Program that allows for instant access to a portion of the money you've already earned
• We also offer several voluntary insurances such as:
• Pet Insurance
• Term and Whole Life Insurance
• Short-term Disability
• Hospital Indemnity
• Personal Accident
• Critical Illness
• Cancer Coverage
• Restrictions apply based on collective bargaining agreements, applicable state law and factors such as pay classification, job grade, location, and length of service.

Posted Salary Range USD $32.00 - USD $35.00 /Hr.