The Legacy Rehab and Care Center

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Business Office Manager

at The Legacy Rehab and Care Center

Posted: 9/11/2019
Job Reference #: 235186758

Job Description

Essential Job Functions


  1. Monthly Insurance Billing
    1. To be submitted within the first 10 days of the end of the billed month. With only Evercare and Medicare A billing being the exceptions:
    2.                                                                i.      Medicare to be billed by date specified by supervisor (or within the 3rd business day of a month, whichever is later).

                                                                    ii.      Evercare to be billed by the 1st business day of the month.

      1. Claim follow-up/research

                                                                     i.      Claim to be followed up within 30 days of submission.

                                                                    ii.      Denied claims require the research by office manager to find reason claim was denied before a corrected claim is sent out to the insurance.

      1. Claim re-billing when denials received

                                                                     i.      If a denial is received, office manager is required to submit a correct claim within 30 days of receiving the denial.

      1. Claims appeals

                                                                     i.      Appeals are to be completed within 30 days of receiving denial.

                                                                    ii.      Office manager is required to collect all documentation by requesting it from the appropriate department as needed, write a concise and clear appeal to the appropriate appeals department, as well as attaching all billing documentation to the appeal that is being sent.

                                                                   iii.      Appeals may also be submitted to supervisor of the Accounts Receivable department for completion, but require approval by the supervisor prior to submission to them.

                                                                   iv.      If appeals are denied, then the appeal denial, along with all submitted documentation to be submitted to the supervisor for further collection efforts.

      1. All billing to be recorded on a billing log and emailed to Assistant Corporate Controller.
      2. Private Pay billing
        1. Monthly statements mailed out 5 days prior to the end of the month that is being billed.
        2. Regular private follow-up
        3.                                                                i.      Phone calls, follow-up letters, etc.

          1. Collect payments from residents in facility that manage their own finances.
          2. Issue receipts for payments
          3. Apply lien/submit to collections/request payment agreements as needed
          4. All billing to be recorded on a billing log and emailed to Assistant Corporate Controller.
          5. Co-Insurance Billing
            1. Co-Insurance billing to be billed within the first 15 days of receipt of the co-insurance remits.
            2.                                                                i.      If mailed to an insurance company follow the procedures from the ‘Monthly Insurance Billing: Section b. Claim follow-up/research, Section c. Claims re-billing when denials received, and Section d. Claims appeals’ respectively

                                                                            ii.      If mailed to a private party, follow the procedures from the ‘Private Pay Billing: Section b. Regular private follow-up, Section c. Collect payments from residents in facility that manage their own finances, and Section d. Apply lien/submit to collections/request payment agreements as needed’ as needed.

              1. All billing to be recorded on a billing log and emailed to Assistant Corporate Controller.
              2. Deposits/Credit Cards
                1. All deposits must be done for the following reasons:
                2.                                                                i.      When deposit is in or over the amount of $4,500.00

                                                                                ii.      On or before the 8th of the month.

                                                                               iii.      On or before the 23rd of the month.

                  1. Make copies for Cash Receipts

                                                                                 i.      Email copy of deposit to Assistant Corporate Controller

                  1. Scan checks to Alliance Bank
                  2. Take checks to National Bank of Arizona (or give to designated employee)
                  3. Record deposit into the corresponding check book with correct date, deposit number and deposit amount.
                  4. Office Manager must also run Credit Cards for residents making payments and keep a copy of the receipt for the resident in the cash receipt folder as well as email a copy of the receipt to the Assistant Corporate Controller.
                  5. Cash Receipts
                    1. Cash Receipts must be entered into Point Click prior to AR meetings as well as before sending out Monthly Private Pay statements.
                    2. All payments must be kept in a folder in a month that it was posted into Point Click and kept in an archive after the month is closed a minimum of 7 years.
                    3. AR  Monthly Aging Meetings
                      1. Office Manager is required to participate in a monthly AR aging review meeting
                      2.                                                                i.      In this meeting, the office manager must show diligent collection efforts for the balances on their AR aging. (which includes, but is not limited to: claims follow-up, billing dates which are 15-30 days than the date of the AR meeting without follow-up (not including appeals), paid dates/amounts, and required adjustments and write offs completed.)

                                                                                      ii.      All balances that do not show proper research, must have proper research and diligent effort prior to the following aging meeting.

                        1. Complete Medicare Bad Debt/Write offs with documentation
                          1. As part of the diligent effort in collections, Office Managers must have copies of all collection efforts for Medicare Bad Debt/Write-Off purposes.
                          2.                                                                i.      Medicare Bad Debt requires the biller to show an initial billing within 60 days from the date of service as well as 180 days of collection efforts.

                                                                                          ii.      Write-Off purposes must also follow the above guidelines but it is required (if the write-off balance is privately owned) that the Office Manager attempts to locate property for a lien prior to submitting paperwork for Write-Off Approval.

                            1. All Medicare Bad Debt/Write-Offs are subject to Administrative and Corporate Approval.
                            2. Monthly Adjustments
                              1. Office Managers are required to complete adjustments monthly as to keep the amount of money that is shown on the AR aging as true as possible.
                              2.                                                                i.      This includes 2% Medicare A adjustments, insurance discounts, payment agreements, etc.

                                1. Front End Financials
                                  1. Assist the admissions department with insurance verification
                                  2.                                                                i.      i.e. Medicare HETs, secondary verification, managed Medicare verification, AHCCCS verification, etc.

                                                                                                  ii.      All insurance verifications must be completed within 15 minutes of receiving hospital face sheet with necessary insurance information

                                    1. Collecting up front co-pays from private parties when insurance has co-pay

                                                                                                   i.      10 day deposit payment required, any amount less requires administrator approval.

                                    1. Daily Census
                                      1. Census must be kept up to date in Point Click and be no later than 2 days behind the completed daily census
                                      2. Transfer patients from ECS to Point Click
                                      3.                                                                i.      Residents must be inputted with all necessary information from ECS face sheet (i.e. name, billing address, date of birth, insurance numbers, physician information, diagnosis codes, prior hospital stay, etc.)

                                                                                                      ii.      Residents must be put in to Point Click with the same accuracy as the ECS face sheet.

                                        1. Complete VOP’s received from Synertx within 24 hours of receiving from Synertx.
                                        2. Transfer RUG scores from ECS to Point Click
                                          1. RUG scores must be updated prior to Monthly insurance billing as well as prior to Month End Closing
                                          2. Ancillary item postings (medical supplies, pharmacy charges, labs, therapy import, etc.)
                                            1. Office Manager is required to input and post all ancillary charges prior to billing as well as making sure the reconcile with the Corporate Controller before closing the AR module
                                            2.                                                                i.      This task may be delegated, but it is the responsibility of the biller for the accuracy of this task.

                                              1. Compile Medicare logs for respective facility
                                                1. To be updated with the patients on the census regularly
                                                2. To be reconciled with admits and discharges and balanced twice a month on the 15th and the last day of the month.
                                                3. Must be updated with RUG scores from ECS regularly
                                                4. All Medicare A billing is to be recorded on this log immediately after its billing.
                                                5.                                                                i.      Paid totals and Paid dates also must be entered into the log as received.

                                                  1. Month End AR Closing
                                                    1. Office Manager is required to balance cash receipts with bank statements, ensure all RUG scores and ancillary charges are entered, and receive authorization from the Corporate Controller prior to starting the Month End AR Closing.
                                                    2.                                                                i.      After receiving authorization from the Corporate Controller, Office Manager then must complete the Month End Workbook ensuring all data balances with the formula’s in the work book.

                                                                                                                    ii.      After work book is complete, Office Manager must email or call the AR Supervisor in order to receive approval, prior to closing the Month End in Point Click.

                                                                                                                   iii.      After the Month is closed, Office Manager must email either Health System Services to inform them that the AR module is closed for the month.

                                                      1. Document Scanning
                                                        1. Office Manager is required to scan all documentation into File Hold system in a timely manner.
                                                        2.                                                                i.      Office Manager is allowed to designate this task to another employee. But is ultimately the responsibility of the Office Manager.

                                                          1. Assist in trust matters as needed
                                                            1. Office Managers will assist with trust matters as long as it doesn’t interfere with direct collections

                                                              Skills In


                                                              1. Use and care of office equipment
                                                              2. Working independently to complete daily activities
                                                              3. Following and maintaining safety standards
                                                              4. Following and effectively communicating verbal and written instructions
                                                              5. Operating a computer utilizing a variety of commonly used and specialized software applications
                                                              6. Prioritizing tasks and time management
                                                              7. Organization


                                                              Knowledge of


                                                              1. Arizona billing and collection laws
                                                              2. HIPPA Privacy Standards
                                                              3. Safety rules, policies and procedures, infection prevention and control procedures
                                                              4. Facility emergency/disaster response and evacuation procedures.
                                                              5. Resident Rights and identifying abuse and/or neglect.


                                                              Ability To


                                                              1. Establish and maintain effective working relationships with associate personnel, residents and resident family members.
                                                              2. Coordinate and conduct meetings.
                                                              3. Read and write clearly.
                                                              4. Understand and follow, quickly and accurately, oral and written instructions.
                                                              5. Maintain confidentiality and work under pressure in a dynamic environment with changing demands and priorities.
                                                              6. Comply with facility policies and procedures.
                                                              7. Communicate orally, speak clearly and persuasively in positive or negative situations, demonstrate group presentation skills and conduct meetings.
                                                              8. Solve problems, identify and resolve problems in a timely manner and gather and analyze information skillfully.
                                                              9. Maintaining confidentiality, remaining open to others’ ideas, and exhibit a willingness to try new things.
                                                              10. Edit work for spelling and grammar, present numerical data effectively, read, and interpret written information.
                                                              11. Prioritize and plan work activities.
                                                              12. Use time efficiently and develop realistic action plans.
                                                              13. Demonstrating accuracy, thoroughness and monitor own work to ensure quality.
                                                              14. Adapt to changes in the work environment, manage competing demands and deal with frequent change, delays or unexpected events.


                                                              Working Conditions/Physical Requirements


                                                              1. Must be able to lift and bear weight of 5 pounds on a daily basis and occasionally lift and bear weight of up to 30 pounds on an infrequent basis.
                                                              2. Requires physical activities including standing, walking, lifting, bending, stooping, pulling, sitting, stretching, turning, grasping, squatting, kneeling and reaching.
                                                              3. Visual acuity to determine the accuracy, thoroughness and quality of work assigned.
                                                              4. Safety-sensitive position pursuant to A.R.S. 23-493.

                                                              Required Minimum Education, Experience and Training


                                                              1. High school diploma or its equivalent.
                                                              2. Clerical experience in healthcare and/or insurance industry preferred.
                                                              3. Basic computer knowledge.
                                                              4. Internet experience.
                                                              5. Telephone and customer service experience.
                                                              6. Experience in Microsoft Office programs.


                                                              SPECIAL JOB REQUIREMENT(S)

                                                              1. Obtain/maintain Arizona Department of Public Safety Fingerprint Card at employee’s expense.
                                                              2. Obtain/maintain CPR Certification.
                                                              3. Complete annual Tuberculosis Testing.
                                                              4. Complete annual in-service training.

                                                              We are an Equal Opportunity Employer. In compliance with the requirements of Title VII of the Civil Rights Act of 1964 Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975, We do not discriminate on the basis of race, color, religion, national origin, sex, age or disability. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

                                  Application Instructions

                                  Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!