#LI-AS1

Position Summary:

Performsbilling related services for Home Health & Hospice programs, including the collectionof Accounts Receivable, Notifications to Medicare, Medicaid, & CommercialInsurance.

Qualifications:

A High School diploma or GED and one (1) year experiencein Medicare/Medicaid, and third-party claim processing, billing, andcollections for both Home Health & Hospice. Must display anaptitude for attaining sufficient knowledge of thevarious billing, software, different insurance programs and contracts. Good customer service, phone etiquette,research, interpersonal and computer skills required.

JobRelations:

Reportsto: Sr Director of Revenue CycleManagement

MainDuties and Responsibilities

1. Responsible for timely and accurate billing of commercial, group insurance, Medicare, Medicaid, managed care, and self-pay home health and hospice accounts.
2. Posts payments and remittance advices, reviews unpaid claims, and uses procedural guidelines to reduce outstanding balances in accounts receivable.
3. Bills and electronically submits claims, performs consistent collection, and accounts receivables follow-up practices, processes payments, identifies appropriate write-offs, resolves credit balances, and responds promptly to payer correspondence.
4. Submits Home Health & Hospice Notices of Election and Notices of Termination/Revocation and/or Notices of Admission to Medicare accurately and promptly.
5. Posts payments and adjustments to accounts receivable as directed.
6. Understands and ensures compliance with Home Health and Hospice billing rules, federal and state billing requirements, and payer contracted billing requirements.
7. Sends patient statements for non-covered services, copays, and deductibles.
8. Writes clear and logical appeal letters, gathers supporting documentation, and submits them to the appropriate insurance carrier appeals department via mail or online.
9. Handles incoming patient correspondence, including scanning and indexing documents.
10. Research alternate electronic means for filing claims, receiving Remittance Advices, and payments. Upon approval, completes registration and establishes procedures for maximizing electronic usage.
11. Gathers statistical and financial data as requested for the preparation of various financial reports.
12. Performs other duties as assigned.