Job Description

DESCRIPTION OF POSITON

This job descriptionis a record of the essential functions of the listed job. The job descriptionprovides the employee, CEO, Human Resources, applicants, and other agencies with a clear understanding of the job, where it fits into the organization, and the skill and work requirements in relation to other jobs. Jobs are always changing to some degree and the existence of the approved job description is not intended to limit normal change and growth. The facility will make reasonable accommodations to otherwise qualified individuals who are capable of performing the essential functions of the job with or without reasonable accommodation.

POPULATION SERVED

The position does not involve direct patient care for a population of patients ages 18 and older. Age specific experience and/or special training and/or expertise are not required to serve this population.

POSITION SUMMARY

The Business Office Clerk supports the Business Office Manager (BOM) with the daily clerical, billing, and resident account functions of the Skilled Nursing Facility. The Clerk serves as a first point of contact for residents, families, and visitors at the business office, assists with admission paperwork and insurance verification, maintains the daily census, supports billing and collections, and assists with resident trust fund transactions under the direction of the BOM. All work is performed in accordance with the policies of Coalinga Regional Medical Center and applicable state and federal regulations.

Requirements

POSITION QUALIFICATIONS

The Business Office Clerk must have a high school diploma or equivalent. One (1) or more years of office, medical office, or long-term care billing experience is preferred, including familiarity with Medicare, Medi-Cal, and commercial insurance. The Clerk must have basic computer skills (email, Microsoft Word and Excel, and data entry), strong attention to detail, good customer service and communication skills, and the ability to keep resident financial and health information confidential.

Ability to maintain assigned work hours: Requires endurance to perform tasks over long periods of work hours.

DUTIES AND RESPONSIBILITIES

· Greets residents, families, and visitors at the business office; answers phones, routes calls, and takes messages.

· Assists with admission paperwork, including collecting insurance cards, identification, and responsible party information, and enters resident demographic and insurance information into the system.

· Verifies Medicare, Medi-Cal, managed care, and commercial insurance eligibility at admission and monthly, and reports any changes to the BOM.

· Maintains the daily census and reports admissions, discharges, transfers, leaves of absence, and bed holds to the BOM.

· Assists with preparing and submitting claims and follows up on unpaid or denied claims as directed by the BOM.

· Posts payments and receipts to resident accounts as directed by the BOM.

· Prepares monthly statements for private-pay residents and tracks Medi-Cal share of cost.

· Assists residents and families with Medi-Cal applications and redeterminations, and tracks pending applications.

· Processes resident trust fund deposits and withdrawal requests, obtains proper signatures, and maintains signed withdrawal forms in each resident’s file, under the direction of the BOM.

· Maintains business office files and records, and scans and files documents in an organized and timely manner.

· Processes incoming and outgoing mail and prepares bank deposits for BOM review.

· Refers billing questions or disputes from residents and families to the BOM.

· Maintains the confidentiality of resident financial and health information in accordance with HIPAA and facility policy.

· All other duties as assigned.