A-Line Staffing is now hiring Healthcare Financial Representative (Hybrid) in Harrisburg, PA. If you are interested in Healthcare Financial Representative (Hybrid)position, please contact Alexis at
Healthcare Financial Representative (Hybrid) Compensation
- The pay for this position is 25.00 per hour paid
- Benefits are available to full-time employees after 90 days of employment
Healthcare Financial Representative (Hybrid) Highlights
- The required availability for this position is Monday–Friday Hours per week: 37.5
Healthcare Financial Representative (Hybrid) Responsibilities
- Conduct initial and follow-up financial reviews of skilled nursing facilities in accordance with established policies, procedures, and state and federal regulations.
- Perform specialized financial reviews and evaluate nursing facility compliance with Medical Assistance billing and reimbursement requirements.
- Provide technical assistance and guidance to nursing facilities regarding MA and Medicare billing requirements, regulations, and documentation.
- Review resident personal care funds and trust accounts to ensure expenditures are appropriate and required fiduciary controls are maintained.
- Compare MA Status Change Reports with nursing facility records to verify payer source accuracy and census reporting.
- Analyze nursing facility accounts receivable to identify potential MA overpayments and coordinate the collection and recovery of improperly paid claims.
- Process and monitor claims adjustments in accordance with established procedures.
- Prepare financial review documentation, reports, and support materials, including the monthly Recovery Report.
- Analyze financial records and review findings to identify billing discrepancies, recurring trends, and potential areas of noncompliance.
- Conduct entrance and exit conferences with designated nursing facility personnel to communicate review objectives, findings, and required follow-up actions.
- Respond to provider inquiries, correspondence, and requests for assistance regarding billing requirements, policies, procedures, and enrollment documentation.
- Coordinate with appropriate state agencies and external stakeholders regarding nursing facility certification, licensure, and ongoing compliance requirements.
- Participate in administrative hearings and defend financial review findings in appeals proceedings, as needed.
Healthcare Financial Representative (Hybrid) Requirements
- Bachelor’s degree or an equivalent combination of education and relevant experience with Medical Assistance billing requirements.
- Working knowledge of Medicaid and Medicare billing regulations and procedures.
- Strong analytical skills and the ability to review financial records, identify discrepancies, and interpret billing and reimbursement information.
- Ability to communicate effectively with nursing facility representatives, providers, state agencies, and other stakeholders.
- Strong written communication, documentation, organizational, and problem-solving skills.
- Ability to manage multiple assignments, maintain accurate records, and meet established deadlines.
Preferred Qualifications:
- Experience in healthcare accounts receivable, financial auditing, reimbursement, or cost reporting.
- Experience reviewing skilled nursing facility financial records and billing practices.
- Familiarity with Medical Assistance regulations, federal financial participation requirements, and nursing facility reimbursement policies.
- Experience with claims adjustments, overpayment recovery, financial reporting, and regulatory compliance reviews.
If you think this Healthcare Financial Representative (Hybrid) position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting!
For more information, please contact
Alexis
Staffing Manager
