Hospice Billing Specialist

Responsibilities

• Prepares and maintains patient billing files.
• Prepares Notice of Elections for Medicare patients and enters data into the Fiscal Intermediaries data entry program.
• Participates in the quality program (IOP).
• Reviews and edits claims prior to billing to ensure accurate and clean claim submission.
• Mets all billing and accounts receivable deadlines.
• Prepares and distributes unsubmitted billing list to appropriate personnel weekly.
• Reviews all remittance advices for contractual adjustments, withholds and bad debt.
• Attaches documentation for justification, as needed.
• Follows-up by phone call to payers on open dates of service for payments, denials and resubmission of claims, if necessary.
• Dates accounts receivable follow-up and maintains in patient billing file.
• Prepares and bills Medicare Secondary Payer claims through the Fiscal Intermediaries direct data entry program.
• Reviews and edits claims in claims correction section of on-line system to ensure on-going processing for payment via direct data entry, daily.
• On a quarterly basis and upon signature by the Director of Operations/Reimbursement, prepares and sends to Fiscal Intermediary Medicare, credit balance reports for each Hospice office.
• Responsible for taking and processing of referrals, when needed.
• Responsible to supervise Billing, Referral Intake and Scheduling personnel in the absence of the Director of Operations/Reimbursement.
• Maintains branch locations monthly unbilled if assigned.
• Reports any ADR’s to Compliance Officer and Regional Director of Clinical Care.

Qualifications

• A high school graduate or the equivalent preferred.
• Must be experienced with PC's and be familiar with common office software, such as Microsoft office and spreadsheets, etc.
• Must be well organized and detail-oriented.
• Must be able to communicate articulately and comprehend written and verbal communications.