Applications are submitted online until the position is filled and/or the posting is closed. After reviewing this job announcement, please click on the link at the bottom of the page to apply online. A resume is required with the application. Further instructions on submission of documents are available in the online application. A resume may not be substituted for an application.

Incumbent supervises and participates in the processing of reimbursements from Part B Medicare and coinsurances for ancillary charges to DERMC. Work is performed in accordance with Federal, state and local standards, guidelines, and regulations that govern long-term care facilities under the direction of the Revenue Controller.

• Supervises the work of subordinate staff, through assignment of work, establishment of priorities, approval of leave requests, and the completion of performance appraisals.
• Applies payments daily from Medicare and coinsurances using Solution One & SOS programs.
• Determines residents’ insurance coverage status and qualifications for either Medicare Part B billing or non Medicare B billing and inputs into appropriate programs.
• Tracks unpaid and rejected claims.
• Organizes billing documentation for enteral and wound care claims.
• Inputs billing information and documentation.
• Prepares requests for missing or additional documentation for wound care from nursing representatives.
• Receives weekly wound care reports, supply orders, and doctor’s orders.
• Prepares and submits claims for wound care to Medicare Part B and obtains acknowledgement reports of accepted claims.
• Receives enteral monthly report from Resident Service Managers and Dietitians and makes any corrections or requests any needed documentation.
• Prints insurance, census, and ICD9 code reports for Resident Services Managers and Dietitians.
• Inputs Part B enteral and projected enteral changes for following months and actual enteral changes on non-B residents.
• Compiles and sends to Medicare reviews for under and unpaid claims.
• Provides in-service information to nursing and dietary staff on the documentation required to support reimbursement for charges related to ancillary services.
• Performs related tasks and other duties as assigned by the Revenue Controller.

• Principles and practices of supervision.
• Medicare and Medicaid regulations regarding reimbursements. 

• Microsoft Office Suite

• Operate a personal computer.
• Relate to and work with ill, disabled, elderly, and emotionally upset people within a long-term care facility.
• Communicate effectively with vendors, employees, applicants, residents, family members, visitors, government agencies, and general public.
• Read, write, and understand written and oral instructions.