Pueblo, Colorado
Agency Financial Analyst Job Opening in Pueblo, Colorado - REPORTS TO: Controller
DIRECT REPORTS: N/A
COMPENSATION: Commensurate with experience
LOCATION: Pueblo, Colorado (no relocation)
COMPANY: PeopleCare Health Services is a rapidly growing, highly respected healthcare company providing home health services throughout the state of Colorado (PeopleCare is the only home health company licensed in all of Colorado?s 64 counties). Many of PeopleCare?s services are provided through the State of Colorado?s Medicaid Home and Community Based Services for the Elderly, Blind, and Disabled (HCBS-EBD) and In-Home Support Services (IHSS) programs for adults and children. For more information see:
Objective: To serve as an integral member of the Company?s finance/accounting team with primary responsibility for invoicing, accounts receivable, and collections.
Primary Responsibilities (including, but not limited to):
Oversight for Agency Financial/Technical Operations: Provide general oversight of daily agency fiscal operations including, but not limited to:
Billing:
Provides oversight for the agency?s timesheet and billing processes for all payers per Controller directive including ensuring current and accurate Prior Authorization Requests (PARs) and timesheets are appropriately filed.
Medicaid:
Responsible for the Agency?s access to the Colorado Medical Assistance Program (CMAP) portal and assists with portal-related issues
Creates Report weekly from the company?s billing software and collaborates with Agency Manager to achieve resolution.
Retrieves PARs from the CMAP and Single Entry Point (SEP) portals and forwards to Agency Manager
In collaboration with Agency Manager, follows up with SEP, Case Managers and/or Supervisors regarding any discrepancies in PAR content, both initially and ongoing
Researches and resolves impediments to ?clean? billing surrounding payment of claims.
Retrieves, files, analyzes, and researches Medicaid Accept/Denial Reports from the CMAP portal
Identifies all errors; identifies and takes required action to resolve
Completes billing spreadsheet to reflect all required information
Creates Held Claims Breakdown from company software
Identifies reasons for delinquency and action required to bill
Follows up with SEPs on delayed PARs or PAR revisions.
Monitors timeliness of denied Medicaid claims, identifies claims at risk, works with Billing Department to ensure billing/rebilling as need to extend timeliness
Provides all relevant to Billing team prior to weekly Billing meeting and collaborates with Billing team to identify and perform follow-up action items from Billing meeting
Aging:
Generates weekly Aging Accounts/Receivable (A/R) report
In collaboration with Billing team, identifies, reviews, researches and resolves impediments to ?clean? billing surrounding rejection/denial of non-Medicaid claims
Commercial Payers:
In collaboration with Billing team, maintains knowledge of claim billing for all non -Medicaid payers including but not limited to: Veteran?s Affairs, Regions 9 and 10, Community Options and other contracts held by PeopleCare Health Services.
Fraud Investigation:
Collaborates with Agency?s Timesheet Validator and Agency Manager to identify any potential instance of fraudulent services reporting
Spearheads investigation to determine and document whether fraud is involved
If fraudulent activity is identified, works with Agency Manager and Administrator to take appropriate action and follow reporting requirements.
Budget: Provides input in the formulation of local agency budget, as well as consistent daily oversight and reporting as required/requested by Controller and/or designate
In collaboration with Agency Manager, analyzes payments, claims, and A/R to produce revenue reports and targets
Reporting: Provides oversight to any required reporting regarding the Agency?s financial operations.
Builds and maintains knowledge and advanced skills with the company?s billing software to create all reports necessary to job function
Meetings: Participates in regular meetings as required by PeopleCare Health Services
Regulatory Compliance: In conjunction with the Controller maintains knowledge of and ensures company compliance with all applicable local, state, and federal laws and regulations concerning the fiscal operations of home care agencies including but not limited to ongoing requirements for continuing professional education.
Community Relations: Actively cultivates strong throughout the service area with key SEP case managers and supervisors, establishing and maintaining a strong company reputation
Misc.: Perform other duties as assigned by the Executive Team of PeopleCare Health Services
Skills & Traits:
Ability to communicate pleasantly, professionally and effectively with office staff and third parties in person, writing and over the phone
Excellent communication and customer relations skills
Demonstrates initiative to collaborate and independently performs high-quality work
Familiarity with the concepts, practices, and procedures of the home care industry
Excellent client interaction skills
Excellent organizational skills
Adaptability to rapidly changing situations
Excellent problem-solving skills
Computer proficiency mandatory
Thorough in all aspects of the job
Compassion for all consumers/clients
Collaborative and coachable
Education:
Associates degree or higher required
Relevant academic, vocational and/or professional education
Experience:
Familiarity with healthcare industry concepts, practices, and procedures preferred
Proficient in the use of standard office software including Microsoft Windows, Excel, Word, and Outlook
Hands-on experience with healthcare billing software preferred
The Billing and Collections Specialist position is full-time with health insurance, 401(k) including company match, and competitive salary commensurate with experience.
Please submit a resume and cover letter including compensation requirements. Regarding compensation, "negotiable" is not an acceptable response, and applications listing such will not be considered.
Job Type: Full-time
Job Location:
Pueblo, CO
Required education:
Associate
Required experience:
healthcare billing: 5 years
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