Medical Biller

POSITION SUMMARY:

The Hospice of Baton Rouge is seeking a skilled Full-Time Medical Biller to support its day-to-day operations. The Medical Biller will be responsible for completing complex Medicare and Medicaid claims to ensure accurate submission, timely follow-up, and full compliance with federal and state regulations. This role will support optimal revenue cycle performance by coordinating with internal staff, patients, and payers to resolve denials, maintain accurate financial records, and facilitate proper reimbursement.

JOB RESPONSIBILITIES:

• Accurately and timely prepare and submit insurance claims for Medicare and Medicaid in compliance with federal and state regulations

• Follow up on unpaid or denied claims; research root causes, resolve discrepancies, and submit effective appeals as needed

• Review and reconcile Explanations of Benefits (EOBs) and remittance advice; ensure accurate payment posting and identify variances

• Communicate with patients regarding account balances, payment plans, and billing inquiries related to Medicare and Medicaid services

• Maintain accurate billing records and documentation in accordance with HIPAA and all regulatory requirements

• Collaborate with other departmental staff, clinical teams, providers, and administrative staff to resolve billing issues and improve claim accuracy

• Stay current with Medicare and Medicaid policy updates, coding guidelines (ICD-10, CPT, HCPCS), and billing regulations

• Utilize medical billing software and Electronic Health Record (EHR) systems efficiently and accurately

• Accurately verify patient insurance information, payment systems, and government program requirements using medical billing software and online platforms

• Confirm compliance with state-specific regulations and ensure all verification data is documented accurately

Education:

• High school diploma or equivalent required
• Associate’s degree in Healthcare Administration or a related field preferred

Certifications:

• Certified Professional Biller (CPB – AAPC), Certified Medical Reimbursement Specialist (CMRS – AMBA), or Certified Billing and Coding Specialist (CBCS – NHA) preferred

Work Experience:

• 2–3 years of medical billing experience in a healthcare setting preferred
• Direct experience with Medicare and Medicaid billing processes required
• Experience working with Medicare, Commercial payers/plans and state-specific Medicaid programs is preferred

Special Skills:

• Strong understanding of Medicare and Medicaid billing regulations, payer guidelines, and claims processing

• Knowledge of ICD-10, CPT, HCPCS codes, and claim form requirements (CMS-1500, UB-04)

• Proficiency in medical billing software and EHR systems

• Familiarity with revenue cycle management and denial management strategies

Other Requirements:

• Exceptional problem-solving and analytical skills
• High attention to detail and accuracy in data entry and claim submission
• Strong written and verbal communication skills for patient, payer, and internal interactions
• Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment
• Ability to maintain confidentiality and handle sensitive financial and health information with discretion
• Understanding of CMS operations and Medicare/Medicaid policy structure preferred