KLC Financial Assistant

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  • JOB SUMMARY    
    • The Finance Assistant ensures accurate billing for residents including Medicare, Medicaid, private insurance and private pay. The role can include billing claims, issuing statements, collecting and posting payments, pursuing denied claims, and working with insurance companies to obtain prior authorization and continued stay approvals. Oversees census and ensures daily changes are captured and up to date.
  • DUTIES AND ESSENTIAL FUNCTIONS
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    • Prepares and maintains accurate and timely bills on a monthly basis.  Processes claims, statements, pursues claim denials, appeals underpaid claims.  Produces payment records for payment audits.  Posts payments received.   Produces statements of patient account activity for responsible parties.  Maintains accurate journals that include cash receipts.    Maintains accurate trust fund records.  Maintains and reconciles miscellaneous cash accounts for the facility.
    • Verifies and enters census and demographic information into system.
    • As directed, pursues collection of past due accounts receivable.
    • Assists residents and/or families with completion of forms to secure financial benefits from State and/or Federal agencies.
    • Receives and responds to inquiries concerning patient accounts.
    • Communicates with insurances for prior authorization and continued stay reviews.  Communicates authorizations status and other pertinent information with team members.  Issues NOMNC, discusses appeal options with residents and /or families.  Submits appeals of NOMNC to QIO.
    • May require managing phone lines and assisting visitors.
  • EDUCATION/LICENSES/CERTIFICATIONS/OTHER REQUIREMENTS
    • Minimum requirement:
      • High School Diploma or GED equivalent.
      • Working knowledge of preparation of financial statements and related accounting functions. 
    • Preferred qualifications:
      • One-year experience in a health care setting. 
      • 2 years accounting experience preferred.
  • WORKING ENVIRONMENT
    • The work environment characteristics described here are representative of those a team member encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the team member may occasionally be exposed to blood or other body fluids, fumes, or airborne particles and toxic or caustic chemicals. This job cannot be performed without exposure to the stresses associated with an intimate, 24 hour residential care environment that delivers care and services primarily to disabled and cognitively impaired residents.  Examples of these stresses include, but are not limited to:  shift rotation, weekend and holiday duty, unusual or impaired behavior by residents, family reactions to having a loved one in the nursing home, death, and dying, oversight of state surveyors, ombudsmen and federal officials, presence of consultants and attorneys, and variable involvement of medical staff. The noise level in the work environment is usually moderate.
  • PHYSICAL DEMANDS
    • The physical demands described here are representative of those that must be met by a team member to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the team member is occasionally required to sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; and talk or hear.  The team member frequently is required to stand and walk.  The team member is occasionally required to climb or balance and stoop, kneel, crouch, or crawl. Occasional physical effort with light to medium objects. Occasionally required to lift objects of 10 to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, and peripheral vision.
    • Constantly required to maintain a stationary position behind a computer.
    • Frequently required to move about inside the department.
    • Constantly required to communicate telephonically and face to face with colleagues and customers.
    • Constantly required to operate a computer and telephone.
    • Occasionally required to lift and/or move up to 50 pounds
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