CareOne

  • Regional Revenue Management Specialist

    Job Locations US-VA-Glen Allen
    Requisition ID
    2018-7051
    Position Category
    Finance
    Position Type
    Full-Time (37.5+)
  • Overview

    Looking for a new career with a dynamic team where you can balance life & work? Look no further, CareVA has just what you are need!

     

    Now Hiring - Regional Revenue Management Specialist,  

     

     CareVA

     

    The CareVA mission is to define excellence within the health care community. We are dedicated to Maximizing Patient Outcomes. We treat Residents, their families and each other with respect, dignity and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our Centers and Communities. We work to maintain the highest standards of care and service for Residents, families and our valued employees.

     

    We are proud to Offer:

    • Competitive Salary
    • Comprehensive Healthcare Benefits
    • 401k Retirement Plan
    • Paid Time Off
    • Opportunities to advance and grow your career
    • And More! 
    • If working with people who are dedicated, compassionate, and concerned about their patients is essential to you, then you'll appreciate being a part of our team. We've built a strong reputation on the outstanding level of care that we provide. We have a graciously appointed facility with strong belief in patient care and service; join us at our beautiful facility!

    Responsibilities

    The Regional Revenue Management Specialist is responsible for providing financial support and assistance to the facility Business Offices in the region. The Specialist will be an expert in Medicaid,  traditional Medicaid and MLTSS plans, providing education and assistance to the center with Medicaid application and redetermination process.  He/She will facilitate and develop good relationships with the Local DSS eligibility workers and the State Medicaid staff.  The Specialist will work with Business Office staff to address billing issues and develop best practices regarding claim format, use of PCC program, electronic billing, ERA and EFTs, and Revenue Cycle Management practices to secure proper and prompt reimbursement.

     

    1. Provide to the facilities Revenue Management assistance to facilitate timely collection of outstanding balances.
    2. Develop and reinforce best practices to be incorporated at the facilities including timely and accurate billing, proper documentation of collection efforts, claim follow-up and appeals, and proper contractual adjustments and write-off procedures. Also become an expert using the PCC software system.
    3. Work with the Managed Medicaid plans to address claim processing issues. Participate on the bi-weekly Virginia DMAS calls with the MCO plans, to make sure Care Virginia issues are addressed and resolved. Work with Pennsylvania facility also on their Managed Medicaid claim issues.
    4. Assist with audits by external agencies and disseminate to the facilities, best practices to minimize audit retractions.
    5. Work with team to improve case management of residents to improve financial profitability.
    6. Provide on an as needed basis, coverage in the facilities for the Business Office Manager and/or AR Assistants so collections is not affected. Also provide training for new staff members.
    7. Participate in month AR Reviews.
    8. Become a Medicaid expert for Virginia, Maryland and Pennsylvania. Understand the approval process, billing requirements and proficient in using their websites for claims.
    9. Provide oversite of Medicaid Pending Process including developing in the facilities a tracking system for redeterminations. Provide education on the Medicaid application process in the facilities. Report to Administrator and other team members of any potential problem cases or noncompliance.
    10. Develop relationships with the various local Department of Social Services and State Medicaid agencies to move cases through the system.

    Qualifications

    1. Minimum of 5 years experience in Long-Term Care industry with excellent billing experience.
    2. AA/AS in Finance or Accounting preferred
    3. Working knowledge of Medicaid application process and requirements Demonstrated ability to evaluate situations, research to gather needed data and analyze to determine root causes and develop solutions. Must possess excellent critical thinking and analytical skills.
    4. Demonstrated ability to evaluate situations, research to gather needed data and analyze to determine root causes and develop solutions. Must possess excellent critical thinking and analytical skills.
    5. Ability to travel within the region, often on short notice
    6. Demonstrate excellent communication skills, both verbally and in writing, with residents, families, vendors, governmental agencies and staff.
    7. Demonstrated skill to provide training to staff on best practices
    8. Proficiency in Microsoft applications, including Excel, Word and Office.
    9. Ability to work independently: to prioritize and accomplish multiple tasks in a fast paced environment.
    10. Ability to work as a team member with multiple facilities and to and be proactive in recommending solutions to improve fiscal performance of the region.

     

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