Billing Specialist in Ashland, Kentucky at Community Hospice Inc

The Billing Specialist is responsible for processing all private insurance, Medicaid, and unrelated drug claims. The Billing Specialist is responsible for follow-up and collections on accounts. They will maintain accurate patient reimbursement data and ensure compliance with regulations and Community Hospice billing procedures.

RESPONSIBILITIES:

- Responsible for obtaining preauthorization for insurance eligibility and benefits upon admission and level of care change.

- Responsible for processing private insurance billing.

- Responsible for processing insurance co-pays and deductibles.

- Responsible for follow-up on insurance denials and collections on accounts.

- Ensures billing is performed timely and accurately.

- Assists with and follows up on Medicaid pending applications.

- Responsible for processing Medicaid Claims

- Responsible for follow-up on Medicaid denials and collections on accounts.

- Processes unrelated drug claims. Ensures unrelated drug charges are billed promptly and accurately.

- Ensures billing is performed timely and accurately.

- Responsible for ensuring compliance with CPT, MCPES & ICD-10 coding of all ARNP/MD claims prior to billing.

- Review all ARNP/MD visit narratives and assign codes for services rendered.

- Conduct audits and coding reviews to ensure all documentation is accurate and precise.

- Comply with all legal requirements regarding coding procedures and practices.

- Monitors accounts receivable, maintains aging of accounts within agency goals.

- Ensure collections on accounts are routinely performed for each reimbursor. Denials are monitored and reviewed.

- Verifies nursing home billing rates are accurate and patient liabilities are recouped.

- Demonstrates knowledge and understanding of hospice reimbursement and billing procedures. Able assist Billing Coordinator or perform billing in her absence.

- Works with MRS to ensure patient financial information and level of care changes are obtained and verified to ensure prompt collections with appropriate financial sources.

- Processes Electronic Medicare election submissions when needed.

- Ensures ledger cards are accurate and level of care changes are made.

- Prepares billing reports for Billing Coordinator and CFO as needed.

- Perform other duties as assigned.

Job Type: Full-time

Expected hours: 32 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• 4 days a week.

Work Location: In person

QUALIFICATIONS:

- College degree or Degree of Certification in Medical Coding/ and/or three years

billing experience.

- Knowledge and experience with Medicare, Medicaid, and private insurance billing procedures.

- Good organizational, interpersonal and communication skills.

- Knowledge and understand of modern office practice and procedures.

- Ability to organize and assess.

- Must demonstrate effective communication skills

- Must be able to work independent of direct supervision.

- Must be able to pass a Driving Records Check, Criminal Background Check, and a Pre-Employment Drug Screen.

Education:

College degree or Degree of Certification in Medical Coding (Required)

Experience:

3 years (Required)