Billing Specialist

Description

 The Billing Specialist is responsible for processing all commercial insurance along with palliative care claims. The Billing Specialist is responsible for pre-authorizations, following up on denials and collections on accounts. He/She will maintain accurate patient reimbursement data and ensure compliance with regulations and Community Hospice accounts receivable and billing procedures. 

RESPONSIBILITIES:

• Report to the Chief Financial Officer.
•  Responsible for obtaining preauthorization for insurance eligibility and benefits upon admission and level of care change.
• Responsible for processing commercial insurance billing. 
• Responsible for processing commercial insurance and palliative care co-pays and deductibles. 
• Process palliative care claims weekly.
• Ensure billing is performed timely and accurately.  
• Monitor accounts receivable, maintains aging of accounts within agency goals.
• Ensure collections on accounts are routinely performed for each reimbursor.
• Ensure denials are monitored and received. 
• Assist billing department with various billing related tasks 
• Demonstrate knowledge and understanding of hospice reimbursement and billing procedures. 
• Assist or perform billing for other payors as needed. 
• Work with CTA to ensure patient financial information and level of care changes are obtained and verified to ensure prompt collections with appropriate financial sources. 
• Process electronic Medicare election submissions when needed. 
• Ensure ledger cards are accurate and level of care changes are made. 

Required Skills & Abilities

• Must be able to participate in the Federal and State healthcare programs. 
• Extreme attention to detail.
• Knowledge and experience with private insurance, palliative care billing procedures.
• Demonstrate knowledge and understanding of private insurance, and palliative care reimbursement and billing procedures.
• Keep a professional appearance and uphold the organization's reputation at all times. 
• Exhibit professional demeanor and appropriate decision-making in stressful situations.
•  Must demonstrate effective communication skills and maintain good working relationships with employees, vendors, patients, and patient families.
• Knowledge and understanding of modern office practices and procedures. 
• Strong grammatical/writing skills.
• 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

Requirements

QUALIFICATIONS:

• College degree or degree of certification in medical/coding and/or two years billing experience. 
•  Knowledge and experience with private insurance, and palliative Care billing procedures. 
• Excellent attention to detail, organizational skills, and confidentiality. 
• Must be able to pass a driving records check (upon hire and annually), criminal background check, and drug screens (pre-employment and randoms).
• Must maintain automobile liability insurance.

Education:

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

Experience:

2 years (Required)