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)