Job Description
At arenaflex, we are committed to delivering exceptional healthcare services to our patients while maintaining a strong focus on revenue cycle management and compliance. As a key member of our team, the Experienced Data Entry Representative will play a vital role in ensuring the timely and accurate billing of Medicaid claims for our Nursing Home and Hospital partners. If you are a detail-oriented and organized individual with a passion for data entry and revenue cycle management, we encourage you to apply for this exciting opportunity. **Job Summary:** The Experienced Data Entry Representative will be responsible for the billing and timely follow-up of all assigned Medicaid claims for Nursing Home and Hospital partners. This role requires strong analytical and problem-solving skills, as well as excellent communication and interpersonal skills. The successful candidate will work closely with our business office and admissions staff, as well as various governmental regulatory agencies, to ensure successful accounts receivable management. **Key Responsibilities:** * Billing of all Medicaid claims via the SSI software (and when appropriate web portal or paper billing), including editing billing data and reconciling all bills via KNS. * Follow-up on all outstanding claims greater than 30 days, ensuring successful resolution in a timely and cost-effective manner. * Run all A/R aging reports after KNS month end to use as an A/R management tool. * Complete A/R spreadsheets and be prepared to review details with management at scheduled monthly review meetings. * Ongoing management of detailed A/R trial balance for Medicaid/Medicaid MMC/MMA payers to ensure proper timeliness of billing claims, appropriate documentation (i.e., authorizations, NOCA's, etc.) are received and included on claims, appeals are submitted within appropriate timeframe, and overall compliance with all Medicaid (State) regulatory guidelines. * Follow-up and facilitate resolution of all denied claims, including identifying and communicating to Director root causes and trends resulting in denials (CBO; Facility; etc.). * Obtain Medical Records from appropriate facilities for the purpose of appealing denied claims. * Ensure that most recent NOCA's are updated in the KNS database and maintained for future audits. * Maintain close working relationships with facility counterparts in business office, admissions office, case management office, medical records office, etc. to ensure effective revenue cycle management. * Utilization of all departmental system tools (i.e., KNS; Trace; SSI; etc.). Identify and communicate any and all systemic issues that may result in payment delays, underpayments, lost revenue, etc. * Billing and follow-up for Medicare co-insurance billing to Medicaid and/or Medicaid MMC/MMA payers for SNF and all other lines of business (i.e., Hospital; Outpatient and Clinics). **Other Duties:** * Perform all other duties as assigned by the Revenue Cycle Manager. * Maintain required license, certifications, and mandatory skill updates. * Comply with all policies, local, state, and federal laws and regulations. * Perform other duties as assigned. **Supervisory Responsibility:** * No direct reports. **Physical Requirements:** * Must be able to lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds, walk, climb stairs or ladders, stand on feet for extended periods of time, etc. * Works in office environment with moderate to loud noise level. * Subject to frequent interruptions. * Work schedule may include working beyond typical schedule, including weekends and holidays. * Hand dexterity required for data entry on keyboard, requiring finger dexterity and eye-hand coordination. **Disclaimer:** The job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Other duties, responsibilities, and activities may change or be assigned at any time. **EEOC Statement:** arenaflex provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. **Requirements:** * High school diploma and two years related experience of a combination of education and training. * Must be knowledgeable with computers, calculators, system applications, spreadsheets, and other related office equipment. * Must have knowledge of computer office/clinical software. * Must be able to read, write, and understand the English language. **Salary Description:** $17.00-$20.00 per hour. If you are a motivated and detail-oriented individual with a passion for data entry and revenue cycle management, we encourage you to apply for this exciting opportunity. Join our team at arenaflex and contribute to our mission of delivering exceptional healthcare services while maintaining a strong focus on revenue cycle management and compliance. Apply now to become a part of our team and take the first step towards a rewarding career in healthcare revenue cycle management. Apply for this job