Insurance Biller (Managed Care)

StoneGate Senior Living

Lewisville, TX

StoneGate Senior Living, a leading provider of Long-Term Care, Skilled Nursing and Rehabilitative Care in Lewisville, TX has an opportunity for an Insurance Biller with Managed Care Insurance experience to join our team! A rewarding career is waiting for you with a company that specializes in long-term and rehabilitative care! If you are an experienced Insurance Biller with Managed Care experience, we have the opportunity for you. This is not a remote position.

As the Insurance Biller you are responsible for verifying and facilitating insurance authorizations for Skilled Nursing patients. Duties may also include communicating with clinical liaisons, insurance carriers, and Skilled Nursing Facilities. The specialist will assist in the intake process for all patients by receiving referrals, gathering and recording pertinent information, verifying insurance/payor benefits, obtaining preauthorization and completing process to admit inpatients to the Skilled Nursing Facilities.

Come be a part of our mission to provide superior clinical care, rehabilitation, wellness, and supportive services that meet the wants, needs, and expectations of our patients and residents. We offer competitive compensation, health, dental, and vision insurance, company paid life insurance, holiday pay, paid time off, employee appreciation events and much more.

We look forward to you joining our team!

Responsibilities:

• Understanding of SNF billing requirements and systems.
• Bills Insurance via UB04 detailed billing, non-episodic
• Tie NOMNCs to Insurance Authorization for billing and appeals.
• Full understand of ISNP systems and ability to bill per guidelines
• Detailed UB04/837 understanding
• Manage large load of claims from multiple facilities within deadlines
• Work closely with Team Members and billing issue resolutions
• Communicates effectively with clinical reimbursement
• Knowledge/understanding of Pharmacy exclusions and related billing procedures.
• Working knowledge of national insurance clearing house systems
• Contact patient’s insurance to confirm and determine amount of coverage and benefits, deductible due, length of stay and if authorization is required.
• Communicates authorization status electronically and verbally if needed. .
• Maintains open communication with Team Members and Clinical Liaisons to ensure teamwork, cooperation and mutual respect.
  
  
  

Requirements:

• High school diploma. College degree in Business preferred
• Basic Accounting/bookkeeping skills needed.
• Must have Managed Care Insurance experience.
• Experience in Skilled Nursing authorizations preferred.
• Strong knowledge and understanding of Medicare, Managed Care, HMO/PPO plans and authorization/referral requirements.
• Ability to understand medical terminology.
• Ability to multi-task and prioritize duties.
• Strong Excel skills
• Excellent organizational skills.
• Uses a computer proficiently.
• Speaks and communicates English effectively, both in verbal and written format.
• Note: this is NOT a coder position.