Billing Specialist is responsible to generate and bill clean claims, as well as, for follow-up of timely and accurate payments of patient accounts.
1. Prepares and maintains patient billing files.
2. Prepares Notice of Elections for Medicare patients and enters data into the Fiscal Intermediaries data entry program.
3. Participates in the quality program (IOP).
4. Reviews and edits claims prior to billing to ensure accurate and clean claim submission.
5. Meets all billing and accounts receivable deadlines during the month and at month-end.
6. Prepares and distributes unsubmitted billing list to appropriate personnel weekly.
7. Reviews all remittance advices for contractual adjustments, withholds and bad debt. Attaches documentation for justification, as needed.
8. Follows-up by phone call to payers on open dates of service for payments, denials and resubmission of claims, if necessary.
9. Documents all accounts receivable follow-up and maintains in patient billing file.
10. Prepares and bills Medicare Secondary Payer claims through the Fiscal Intermediaries direct data entry program.
11. Reviews and edits claims in claims correction section of on-line system to ensure on-going processing for payment via direct data entry, daily.
12. On a quarterly basis and upon signature by the Director of Operations/Reimbursement, prepares and sends to Fiscal Intermediary Medicare, credit balance reports for each Hospice office.
13. Responsible for taking and processing of referrals, when needed.
14. Responsible to supervise Billing, Referral Intake and Scheduling personnel in the absence of the Director of Operations/Reimbursement
15. Maintains branch locations monthly unbilled if assigned.
16. Reports any ADR’s to Compliance Officer and Regional Director of Clinical Care.
- A high school graduate or the equivalent preferred.
- Must be experienced with PC's and be familiar with common office
software, such as word processing and spreadsheets, etc.
- Must be well organized and detail-oriented.
- Overnight travel may be required.
- Must be able to communicate articulately and comprehend written and
- Must be able to function efficiently in a stressful work environment.