Medicaid Billing Specialist - Hospice

At Suncrest Hospice our goal is to change the expectation of hospice care in your area by providing exceptional care and service to our patients.

About the role

We are looking for an experienced Medicaid Billing Specialist who is familiar with the intricacies of Medicaid billing rules and regulations to join our growing team. This position is responsible for timely and accurate submission of Medicare hospice claims, NOE filing, claims follow-up, payment posting review, denial resolution, and ensuring compliance with CMS and hospice billing regulations.

Responsibilities

• Submit Notices of Election, Notices of Transfer/Revocation, etc.
• Send out clean claims on a monthly and as-needed basis in a timely manner using EMR or billing software.
• Submit claims/NOEs using DDE entry, as needed.
• Monitor unpaid claims, making phone calls and written appeals as necessary.
• Investigate and resolve hard-to-collect claims.
• Track common claims errors and create solutions.
• Work with other hospice companies for sequential billing issues.
• Audit patient files as needed for accuracy in billing.
• Work with the Accounting team to report potentially uncollectible debt, assist with payments and remits.
• Familiarity with PECOS and submitting changes, as needed.
• New office EDI setup with the MAC.
• Resolve a variety of issues with MACs as they arise.
• Manage internal user administration in MAC websites.

Requirements

• Minimum 2 years of Medicare hospice billing experience.
• Strong understanding of:
  • Hospice claims billing
  • NOE submission requirements
  • Hospice benefit periods and recertifications
  • Medicare DDE systems (Palmetto, NGS, etc.)
  • Hospice UB-04 billing requirements
• Experience resolving Medicare claim edits and denials.
• Knowledge of hospice eligibility and transfer billing rules.
• Strong organizational and time-management skills.
• Ability to work independently in a fast-paced environment.
• Proficiency in Excel and billing software systems.

Preferred Qualifications

• Experience with MatrixCare or similar EMR/billing platforms.
• Knowledge of Medicaid and Managed Care hospice billing.
• Hospice and/or Home Health experience.
• Use of MatrixCare, Waystar.
• Competency using computers (i.e., web portals, downloading, uploading, scanning, etc.).
• Experience with MS Word and Excel.

Skills

• High attention to detail.
• Problem-solving.
• Accounting mindset.
• Ability to adapt to a changing environment.

Benefits

• Medical, Dental, and Vision insurance.
• Paid Time Off.
• 401k plan with employer match and 100% vesting after 90 days of employment.
• A culture with an emphasis on appreciating and valuing the team member.
• The opportunity to be part of a rapidly growing national company, with possible position upgrades.

Pay

Pay range $23-$25 hourly, DOE.

Schedule

Monday - Friday, Full Time (flexibility for remote or in-office).