Job Description
Job Location: Pleasant View Home - Inman, KS 67546Purpose:
The Financial Coordinator for Pleasant View Home is responsible for managing resident financial coverage related to Medicare, Medicare Advantage Plans, and Medicaid. This position ensures accurate payer source identification, timely reimbursement, and completion of Medicaid applications while maintaining compliance with state and federal regulations. The Financial Coordinator works closely with admissions, nursing, business office staff, residents and families to support the financial stability of the facility and continuity of resident care.
Essential Functions (with or without reasonable accommodations):
The following job functions have been determined as essential to the position of Financial Coordinator at Pleasant View Home.
- Coordinate Medicare and Medicare Advantage billing and reimbursement processes for skilled nursing residents.
- Verify insurance eligibility, benefits, and coverage at admission and throughout the resident stay.
- Handle and be efficient in long-term care insurance.
- Complete, submit, and track Medicaid applications, renewals, spend-downs, and supporting documentation.
- Educate residents and families on Medicaid eligibility requirements, financial responsibilities, and application timelines.
- Serve as liaison with state Medicaid agencies, managed care organizations, and insurance carriers.
- Monitor pending applications and follow up to ensure timely approvals and avoid coverage gaps.
- Maintain accurate resident financial, insurance, and application records in compliance with HIPAA and facility policies.
- Collaborate with Admissions, Social Services, Nursing and the Business Office to ensure appropriate payer source management.
- Review and address billing discrepancies, denials, and delayed payments.
- Assist with state surveys, audits, and financial documentation requests.
- Stay current on Medicare, Medicare Advantage, and Medicaid regulations affecting skilled nursing facilities.
- Perform other related duties as assigned by supervisor.
- Assist billing specialist with monthly billing functions.
Work Schedule:
This position is primarily office-based, working a Monday-Friday schedule. Some weekends might be needed if that is what will best assist the residents’ families. Typically, the Financial Coordinator would work 8am-4:30pm, with a 30-minute unpaid lunch. The exact schedule is flexible and will be determined by the supervisor.
QualificationsEducation Required:
- High school diploma or equivalent required.
- Associate or bachelor’s degree in healthcare administration, business, or related field preferred.
Experience:
- Minimum of one year experience with Medicare, Medicare Advantage, and Medicaid processing in a nursing home or skilled nursing facility.
- Knowledge of state Medicaid eligibility rules and long-term regulations.
- Proficiency in electronic health records and long-term care billing systems.
Physical, Emotional and Interpersonal Requirements:
The employee must be able to:
- Be at least 18 years of age.
- Clearly speak and write the English language
- See, hear or use prosthetic devices to enable use of the senses adequately.
- Sit for extended periods of time.
- Comfortable with communicating via phone, email, etc.
- Excellent communication skills with the ability to explain complex financial information compassionately.
- Attention to detail and accuracy.
- Ability to manage multiple resident accounts and deadlines.
- Strong follow-up and problem-solving skills.
- Ability to work independently and as part of an interdisciplinary team.
- Commitment to resident confidentiality and ethical standards.
- Strong organizational and time-management skills.
- Maintain good general health and demonstrate emotional stability
- Deal with frequent interruptions and some stressful situations.
- Make independent decisions when circumstances warrant such action.
- Deal tactfully with personnel, residents, family members, visitors, and the general public.
- Work harmoniously with other personnel.
