The Medical Billing Specialist assumes responsibility for billing payers for hospice services performed, monitoring the collection, and posting payments to patient accounts.
Hospice billing strongly preferred
Responsibilities
Files all billing forms for reimbursement from payer sources.
Responds to payer sources for requests for further information on claims.
Monitors aging of accounts receivable and re-bills, as necessary until the amount due is collected.
Files all bills accurately and completely in accordance with payer instructions.
Reviews new-admission records as posted in the computer to verify accuracy of billing information.
Verifies patient policy/benefit information with payer sources and coordinates prior-authorization if required.
Ensure eligibility is verified on admission and accurately maintained and followed up accordingly to prevent lost revenue for Medicaid clients as required.
Notifies Administration of any missing documentation required to complete billing.
Answers routine billing questions from admissions staff, patient care staff, and patient families/caregivers as needed.
Identifies and resolves billing issues involving other Hospice providers as required by payer guidelines.
Performs duties associated with re-billing and collections of Medicare, Medicaid, HMO/PPO claims in accordance with best business practices.
Calls insurance companies regarding denials and non-payment of billed accounts.
Responsible for identifying problems and solutions or enhancements to resolve billing issues.
Responsible to monitor ADR request and notify Administrators promptly.
Responsible to monitor and track ADR denials and communicate to Administrators.
Maintains billing files
Performs other duties as assigned.
Participates in educational activities and attends routine staff meetings.
Participates in training as required by Medicare/HMO/PPO/Hospice Guidelines in-order to comply with billing regulations and changes in the industry.
Maintains strictest confidentiality and adheres to all HIPAA guidelines/ regulations
Qualifications
Working knowledge of basic computer programs.
Ability to read, understand and follow oral and written instructions.
Ability to read and interpret complex instructions, regulations, or other correspondence from payer sources.
Ability to establish and maintain effective working relationships with others.