Billing Specialist in Rockville, Maryland at MONTGOMERY HOSPICE INC

Category: Finance
Type: Company Employee
Status: Full-Time /Non Exempt
Benefits Eligible: Yes
To review benefits, please visit our website:
https://montgomeryhospice.org/about-us/careers/
Position Summary:

The Biller is responsible for all aspects of Hospice and palliative account activities, including billing, collections, claims, payment posting and appeals. They communicate with patients, caregivers, insurance providers, physician practices, administrative and clinical staff to determine eligibility, generate invoices, and collect payment for services provided by Hospice.

Minimum Qualifications:
• Education: High School Diploma or equivalent required. Associates degree or higher preferred.
• Experience: Minimum of two years of experience with Medicare, commercial billing, payment positing and collections.
• Must possess the ability to understand and communicate with payer contract language.
• Demonstrated understanding of Medicare, Medicaid, and Commercial payer requirements.
• Knowledge of medical billing systems UB04, CMS-1500, and clearing houses – hospice and Medicare experience preferred.
• Proficient in Microsoft Word, Microsoft Excel, and telecommunication tools such as Microsoft Teams and Zoom.
• Excellent verbal and written communication skills and ability to communicate with internal and external stakeholders.
• Must be dependable and self-reliant.

Duties and Responsibilities:
• Maintains effective communication with patients, caregivers, insurance providers, and) staff regarding billing procedures and eligibility for services.
• Performs any pre-billing functions necessary to ensure claims are ready for submission to the payer.
• Submits claims in a timely manner to the payer.
• Reviews initial claim/ batch of rejection notices and re-submit claims with corrections to the respective payers. Monitor billing cycles to ensure proper rates are in effect.
• Maintains and updates patients’ data in the EMR system to affirm accurate and adequate data is maintained in files concerning patients’ billing status.
• Keeps informed of Medicare, Medicaid, and commercial insurance regulations to ensure all billing activity is kept in compliance with current insurance policies.
• Handles insurance inquires and requests from payer sources and follows up on initial contact until issues or claims are settled.
• Must attend Finance Department meetings and other meetings when required.
• Reviews outstanding balances over 30 working days with follow up to payer source for expected payment and release date.
• Monitors time interval between claim filings submission, and receipt of claim payments.
• Prepares monthly aging of accounts receivable to assist management with pertinent data related to cash flow.
• Maintains scheduled billing cycles for patients’ accounts.
• Maintains supporting documentation and detailed notes in patients’ billing files.
• Efficiently utilizes computer systems and various remote telecommunication platforms to increase productivity and effectiveness.
• Continually assesses their own skill and knowledge base and actively seeks additional training through available resources.
• Comes to meetings prepared to discuss pertinent issues.
• Receives, evaluates, and discusses criticism in a professional manner.
• Keeps abreast of current issues pertinent to the profession.
• All other duties as assigned.

EEO Statement: Montgomery and Prince George's County Hospice is an equal opportunity employer and makes all employment decisions based on job related qualifications, merit, and business needs, without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), gender identity or expression, sexual orientation, national origin, age, disability, genetic information, marital status, military or veteran status, or any other characteristic protected by applicable federal, Maryland, Montgomery County, or Prince George’s County law