Billing Associate - Crown Pointe Estates

Location:

Sioux Center, IA

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Discover a Career of Faith and Healing: For over 70 years, Sioux Center Health has served patients with Jesus’ healing ministry. With eight locations located in Sioux Center, Iowa and surrounding communities, we take great pride in providing superior care in our state-of-the-art facilities.

A Career that You Will Love: There’s no other way to say it: You will love working here. Between our strong mission and our great people, we have nurtured a pretty exceptional culture at Sioux Center Health.

A Chance to Make a Difference: Working with us means making a real difference in the lives of our community members. Your talents and your passions are truly appreciated here. In addition to the service we provide, Sioux Center Health also supports our community with sponsored programs and events, and other volunteer work. If this is your passion, you need to consider joining our team driven to provide quality care and services within a caring Christian culture.

Position Highlights

At Sioux Center Health, our people are the heart of everything we do. Guided by a strong mission and a commitment to exceptional care, we've built a stable, thriving organization where employees make a meaningful difference. Our dedication to excellence is reflected in the recognition we have earned. Sioux Center Health has been named a Top Workplace in Iowa, received Best of the Northwest honors in 13 categories—including Best Place to Work—and earned a Five-Star Patient Survey Rating from the Centers for Medicare & Medicaid Services (CMS). We have also been recognized as a Chartis Top 100 Critical Access Hospital and Top Hospital in Iowa. Our Care Center has received the LeadingAge Excellence in Workplace Award, reflecting our commitment to creating a positive environment for both residents and employees. Beyond our organization, you'll find an outstanding community to call home. Sioux County was ranked #4 in the nation among the Healthiest Communities by U.S. News & World Report and CVS Health, reflecting the high quality of life and strong community values that make this region a great place to live, work, and grow.

Summary

• The Billing Associate is responsible for coordinating resident billing, insurance verification, reimbursement processes, and financial counseling services for residents and their families. This position serves as a key resource regarding Medicare, Medicaid, private insurance, managed care plans, and private-pay obligations while ensuring accurate and timely billing, collections, and compliance with applicable regulations.

General Hours of Work

• Monday - Friday, Days

Education and/or Experience

• Associate degree in Business, Accounting, Healthcare Administration, Finance, or related field preferred. Minimum of two years of healthcare billing, patient accounts, insurance, financial counseling, or business office experience preferred.  Experience in long-term care, skilled nursing, or healthcare reimbursement strongly preferred. Working knowledge of Medicare, Medicaid, managed care, and insurance billing practices preferred. Equivalent combination of education and experience may be considered. Medical Terminology preferred. Must possess working knowledge of CPT/ICD-10 coding, insurance practice and billing software.

Certificate, Licenses, Registrations

• n/a

Essential Functions

Resident Financial Counseling

• Meet with prospective residents, residents, and family members to explain financial obligations and payment options.
• Provide guidance regarding Medicare, Medicaid, long-term care insurance, managed care plans, and private-pay responsibilities.
• Assist residents and families with Medicaid application processes and required documentation.
• Educate residents and responsible parties regarding billing statements, insurance benefits, and account balances.
• Maintain confidentiality of resident financial information in accordance with HIPAA and organizational policies.

Billing and Account Management

• Prepare and submit accurate resident billing for long-term care, skilled nursing, and ancillary services.
• Verify insurance coverage, eligibility, authorizations, and benefit limitations.
• Process Medicare, Medicaid, managed care, long-term care insurance, and private insurance claims.
• Monitor resident accounts receivable and follow up on outstanding balances.
• Investigate, resolve, and document billing discrepancies and claim denials.
• Maintain accurate resident financial records and supporting documentation.
• Generate and review billing reports, aging reports, and account reconciliations.

Collections and Follow-Up

• Contact residents, families, insurance companies, and responsible parties regarding unpaid balances.
• Establish payment plans in accordance with facility policies.
• Follow collection procedures while maintaining positive customer relationships.
• Document collection activities and account status updates.

Compliance and Regulatory Responsibilities

• Ensure billing practices comply with federal and state regulations, Medicare and Medicaid requirements, and facility policies.
• Maintain up-to-date knowledge of reimbursement regulations and payer requirements.
• Assist with audits and provide requested documentation.
• Support compliance efforts related to resident financial records and reimbursement activities.

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Collaboration

• Work closely with Admissions, Social Services, Nursing, and Business Office staff to ensure accurate payer information.
• Communicate changes in resident payer status to appropriate departments.
• Participate in care conferences and admission meetings as needed to address financial matters.
• Performs other duties and responsibilities as assigned.