What are the responsibilities and job description for the Hospice Biller position at Longwood Hospice?
Longwood Hospice Part-Time Biller, 24 hours per week - This postion can be done remotely with periodic, in-person meetings at our Brookline office
Position Summary:
Responsible for the accurate and timely billing of hospice services in accordance with Medicare, MassHealth, commercial insurance, and agency policies and procedures. Ensures claims are processed efficiently while maintaining compliance with CMS Conditions of Participation, Massachusetts Department of Public Health regulations, HIPAA standards, and payer-specific requirements. Monitors accounts receivable, resolve billing issues, and collaborates with clinical and administrative staff to support compliant reimbursement practices.
Position Qualifications and Entrance Requirements:
High school diploma or equivalent required; Associate degree in healthcare administration, accounting, or related field preferred.
Minimum of two (2) years medical billing experience required.
Hospice or home health billing experience strongly preferred.
Knowledge of Medicare hospice billing regulations and MassHealth requirements required.
Experience with UB-04 claim forms, electronic billing systems, and clearinghouses required.
Experience with MatrixCare or similar EMR/billing systems preferred.
Strong organizational, analytical, and problem-solving skills required.
Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
Must possess strong verbal, written, and interpersonal communication skills.
Must demonstrate competency with computers including Microsoft Office applications.
Essential Job Functions and Duties:
Processes and submits hospice claims to Medicare, MassHealth, commercial insurance carriers, and private pay sources accurately and timely.
Reviews patient records and supporting documentation to ensure billing accuracy and compliance with federal and Massachusetts regulations.
Maintains working knowledge of Medicare hospice billing requirements including NOE, NOTR, revocations, transfers, discharges, and benefit periods.
Verifies insurance eligibility, payer authorization requirements, and hospice benefit coverage.
Monitors claim status and follows up on unpaid, denied, or rejected claims promptly.
Researches and resolves billing discrepancies and communicates with payers regarding claim issues and reimbursement status.
Posts payments, adjustments, denials, and contractual allowances accurately within the billing system.
Maintains and reconciles receivable accounts and aging reports.
Coordinates with intake, clinical staff, and leadership to obtain required documentation necessary for billing compliance.
Assists with audits, ADR requests, PEPPER reviews, and compliance activities as directed.
INDHP