AR Reimbursement Specialist

Volunteers of America National Services- PACE is seeking an Accounts Receivable Reimbursement Specialist to service our PACE communities.

Schedule: M-F 8:00 AM-5:00 PM 

*Fully Remote 

Benefit Highlights:

• 403(b) Retirement Plan
• Career scholarships;
• Continuing career education and leadership programs;
• Dental and Vision Insurance
• Paid Time Off (Vacation, Holiday & Sick Days)

About the Job:

To ensure that the financial and reimbursement functions of Senior CommUnity Care PACE Organizations are done in a timely and accurate manner.

Essentials: 

• Assumes specific responsibilities relating to Billing and Accounts Receivable processing.
  1. Assist in all revenue billing, including Medicare and Medicaid.
  2. Assist in all Accounts Receivable duties and prepares adjustments as necessary.
  3. Submits required periodic reports to Medicaid, Medicare and other third payers.
  4. Reconciles monthly detailed revenue.
  5. Create and mail out private pay invoices.
  6. Cash Fax log.
  7. Support PACE Center Enrollment staff in reporting census and submitting paperwork for new enrollments and dis-enrollments monthly to enrollment services vendor.
  8. Enter each new enrollee’s financial information in AR system.
  9. Work with PACE Center Enrollment staff, Pharmacy & Part D Compliance Coordinator, and enrollment services vendor to complete proactive enrollment actions and address retroactive enrollment issues impacting payments.
  10. Review monthly P2P reports, PDE reports, and report ESRD participants.
  11. Download and review 820 Medicaid payment files monthly.
  12. Download and review CMS Medicare MMR files.
  13. Maintain and update current participants’ financial information as changes occur.
  14. Report monthly census to corporate accounting manager and also corporate secretary.
  15. Complete monthly CMS Attestations with Executive Directors.
  16. Complete monthly Medicaid Reports to State Worker.
• Assumes specific responsibilities in the preparation of month-end reports and back up, and submits month-end information to Corporate Office.
• Assumes specific responsibility for preparation of regular Part D reporting as required by the Medicare Part D program.
• Responsible for implementing and following all CMS Part D policies and procedures including coordination of benefits, TrOOP reporting, and PDE submittal process.
• Completes monthly Part D reserve calculation for submittal to VOANS accounting.
• In collaboration with VOANS staff, assist in the completion of annual Part D bids.
• Completes Part D auditing as requested by VOANS leadership.
• Assists other facility personnel in the proper use of data processing equipment as needed.
• Assists Regional VP of PACE Operations, Director of Health Plan Operations and other VOANS leadership with facility financial audits.
• Performs other duties or special assignments as directed by the Director of Health Plan Operations and Regional VP of PACE Operations.

Required Qualifications:

• Associate Degree with major concentration in areas of bookkeeping or data processing, or three (3) years’ bookkeeping or data processing experience.
• Minimum one year of experience as a full charge bookkeeper, preferably in a healthcare setting. Medicare and Medicaid billing experience are desirable.
• Ability to communicate and work effectively with various levels of facility and corporate staff, participants, family members and the public.

At VOANS, we celebrate sharing, encouraging and embracing diversity. Equal employment opportunities are available to all without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, parental status, sexual orientation, gender identity, gender expression, genetic information, military and veteran status, and any other characteristic protected by applicable law. We believe that blending individual strengths and unique personal differences nurtures and supports our organizations’ shared commitment to our mission and creates an inclusive and diverse environment where everyone feels valued and has the opportunity to do their personal best