Billing Reimbursement Specialist
SUMMARY
The Billing Reimbursement Specialist is responsible for performing a range of accounting and billing functions essential to the effective management of the accounts receivable system at Morse Health Center. This role ensures the accurate and timely processing of resident billing, payment posting, and reimbursement activities for the Skilled Nursing Facility (SNF) residents. The Specialist works closely with residents, responsible parties, insurance providers, and internal departments to facilitate clear communication, resolve billing inquiries, and maintain compliance with regulatory and organizational standards. A strong emphasis is placed on attention to detail, financial accuracy, and delivering exceptional customer service in a healthcare setting.
ESSENTIAL DUTIES AND RESPONSIBILITIES
• Maintain and update the daily census records to ensure accuracy in resident tracking and billing.
• Verify insurance benefits and eligibility for Skilled Nursing Facility (SNF) residents before or during admission.
• Communicate insurance coverage details to residents and/or responsible parties in a clear and timely manner.
• Review, prepare, and distribute private pay statements to residents or responsible parties.
• Perform follow-up and collection activities on outstanding private pay balances.
• Submit co-insurance claims to appropriate payers following established billing procedures.
• Conduct follow-up and collection on outstanding co-insurance balances to ensure timely reimbursement.
• Collect and post payments for miscellaneous charges and services not covered by insurance.
• Apply payments from insurance and private pay sources accurately and reconcile them to the cash receipts ledger.
• Respond to billing inquiries and written correspondence with appropriate documentation and professionalism.
• Performs all other duties as assigned.
SUPERVISORY RESPONSIBILITIES
This position has no supervisory responsibilities.
QUALIFICATIONS EDUCATION and/or EXPERIENCE
To perform this job successfully, an individual must be able to perform each primary function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
• One year certificate from college or technical school; or three to six months related experience and/or training; or equivalent combination of education and experience.
• Minimum 2-5 years of experience.
LANGUAGE SKILLS
Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the public. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.
MATHEMATICAL SKILLS
Ability to work with mathematical concepts and to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
REASONING ABILITY
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
CERTIFICATES, LICENSES, REGISTRATIONS
None required.
This position requires a background screening through the Care Provider Background Screening Clearinghouse. For information on the requirements, please visit the Clearinghouse Education and Awareness website at https://info.flclearinghouse.com