LONG TERM CARE MEDICAID BUSINESS OFFICE SPECIALIST

LONG TERM CARE MEDICAID BUSINESS OFFICE SPECIALIST

Essential Duties and Responsibilities

Experience in a long-term care facility and knowledge of the healthcare business office environment are required for this position.

Experience with all aspects of Maryland Long Term Care Medical Assistance is required.

• Provide daily administrative and clerical support to the Business Office Manager and facility leadership.

• Assist with maintaining accurate resident demographic, financial, insurance, and billing information.

• Assist with Medicare, Medicaid, managed care, and private pay documentation as assigned.

• Review documents for completeness, accuracy, and required signatures.

• Assist with collecting and organizing information needed for Medicaid applications, renewals, and eligibility verification.

• Assist with following up on outstanding documentation, missing information, and pending accounts.

• Assist with reviewing and tracking outstanding balances and communicating concerns to the appropriate Business Office staff.

• Answer telephone calls, respond to routine questions, take messages, and direct residents, families, vendors, and other callers to the appropriate department.

• Provide professional customer service to residents and their responsible parties regarding routine billing and account questions.

• Assist with preparing correspondence, reports, spreadsheets, forms, and other business office documents.

• Maintain organized electronic and paper files in accordance with facility procedures and confidentiality requirements.

• Enter and update information in facility computer systems and billing-related software accurately and timely.

• Assist with obtaining and maintaining required resident financial documentation.

• Assist with tracking payments, deposits, receipts, and other financial documentation as assigned.

• Work closely with the Business Office Manager, Administrator, Admissions, Social Services, Nursing, and other departments to obtain information necessary to maintain accurate resident accounts.

• Assist with preparing documentation for audits, surveys, and internal reviews.

• Maintain strict confidentiality of resident, employee, financial, and other sensitive information in accordance with facility policies and applicable regulations.

• Follow all facility policies and procedures, including HIPAA, privacy, security, and record-retention requirements.

• Assist with special projects and other administrative duties as assigned by the Business Office Manager or Administrator.

Qualifications and Experience

• High school diploma or equivalent required.

• Previous business office, medical office, healthcare, long-term care, billing, accounts receivable, or administrative experience preferred.

• Experience working in a skilled nursing or long-term care facility is strongly preferred.

• Experience with Medicare, Medicaid, insurance billing, resident fund trust accounts, or healthcare reimbursement is a plus.

• Strong computer skills, including Microsoft Word and Excel and long-term care software applications.

• Excellent organizational skills and attention to detail.

• Ability to prioritize multiple tasks and meet deadlines.

• Strong written and verbal communication skills.

• Ability to maintain confidentiality and handle sensitive financial and resident information professionally.

• Ability to work effectively with residents, families, employees, insurance representatives, and facility leadership.

• Must demonstrate professionalism, dependability, accuracy, and a commitment to providing excellent customer service.