Medicaid Resident Account Representative

Are you interested in working for a mission-driven organization that continues to grow and is dedicated to providing quality services to its residents? Do you want your next job to offer you the opportunity to serve while allowing you to grow personally and professionally? Explore careers with Charles E. Smith Life Communities!

OUR MEDICAID PATIENT ACCOUNTING SPECIALIST POSITION

The primary focus for our Medicaid Patient Accounting Specialist is collecting the Resident Resources Accounts Receivable with accuracy and within the required time frames. This role will address all financial questions and concerns from residents and their families related to the calculation of the Resident Resources as well as the obligation of the organization to collect the Resident Resources as determined by the State of Maryland. In addition, this position will provide back-up support to our Medicaid Customer Service Specialist and assistance to the Medicaid County Caseworkers and any other entity that impacts the Medicaid resident account. All transactions must be completed in accordance with contractual terms and complex regulations governing private pay, Medicare, Medicaid and Managed Care.

ABOUT CHARLES E. SMITH LIFE COMMUNITIES

Charles E. Smith Life Communities (CESLC) is a faith-based nonprofit senior services organization located in Rockville, Maryland, delivering quality care and meaningful life experiences to older adults with dignity and compassion rooted in Jewish values. Our team of over 1,000 members represent a very wide range of cultural backgrounds, ethnicities, and faiths.

MAIN RESPONSIBILITIES

• This position requires a thorough understanding of the Medicaid program as it relates to skilled nursing facilities and the ability to functionally apply the program requirements to related areas of responsibility. Must be able to explain these complex requirements to family members and residents.
• Must possess excellent communication skills. This position demands continuous professional interaction with family members, state agencies, attorneys, financial institutions, as well as peers, supervisors and other departments.
• Must demonstrate strong customer service skills to ensure a high level of supportive service to our families by addressing their financial concerns and inquiries.
• Monitor all Medicaid approved Resident Resource accounts to include the analysis, timely collection, and disposition of the account. Ensure the accuracy and timeliness of reported balances on the A / R aging report and resident Statements of Account.
• Ability to analyze complex accounts. This includes a comprehensive understanding of the flow of the RFMS accounts and the calculation of the Medicaid and Resident Resource payments.
• Notify MA approved resident / family members of their obligation to pay the monthly resources to cover the cost of care. Ensure payment is received timely each month.
• Provide back-up support for the annual Medicaid Recertifications completed each month to ensure all are completed timely.
• Assist with the Medicaid application process as requested by the Medicaid Billing Supervisor. This role provides back-up support to the Medicaid Customer Support Specialist as needed to ensure all Medicaid approval requirements are met timely and effectively for all MA pending residents.
• Contact insurance companies for cash values and any other policies or plans related to the financial status of the resident.
• Must be able to properly interpret an NOE, determine any required changes and update the system accordingly. In addition to resolving the account, must be able to interact with the RFMS team to ensure they are updated with changes, as both systems must accurately reflect the correct information as provided by the Medicaid program.
• Assist in PEME applications as requested by the Medicaid Billing Supervisor.
• Assist in the calculation and appropriate recordation of the UCC charges into the correct payer account as requested, and as instructed by the Medicaid Billing Supervisor.
• Attend scheduled A / R review meetings with the Accounts Receivable Supervisor, Medicaid Billing Supervisor, Director of Resident Accounting and CFO.
• Maintain accuracy of PointClickCare (PCC) data base.
• Ensure that all approved days and charges have been properly accounted for in PCC. Review resident accounts for accurate charges and payments.

EDUCATION & EXPERIENCE

EMPLOYEE BENEFITS

As a Medicaid Patient Account Specialist enjoy our competitive total rewards package :

LOCATION

This position is based in our Finance Department located in the Dekelboum Building, located at 6121 Montrose Road in Rockville, Maryland.

SHIFTS & STATUS

This is a FULL TIME HOURLY position with standard business hours.