Job Description

Hospice Billing Specialist

Location: Houston, TX | Full-Time | MondayFriday, 8:30 AM 5:00 PM

About the Role:

The Hospice Billing Specialist plays a critical role in supporting quality patient care by managing the billing process for hospice services. This position is responsible for preparing, submitting, and monitoring claims to ensure timely reimbursement from Medicare, Medicaid, and private insurance providers. Key responsibilities include verifying insurance coverage, processing payments, addressing and resolving denied claims, and maintaining accurate patient and billing records. The ideal candidate demonstrates strong attention to detail, proficiency with billing software, a solid understanding of relevant billing regulations, and effective communication skills to collaborate with internal teams and external stakeholders.

Key Responsibilities:

Insurance Verification

• Verifies patient insurance eligibility, benefits, and requirements before claims are submitted.
• Verifies and maintains accurate and up-to-date patient medical and billing information.
• Ensures that all required patient information is present prior to preparing claim.

Claim Submission

• Utilizes appropriate forms for billing submission.
• Prepares and submitstimely billing of all patient accounts including Medicare, Medicaid, third party payersand patient co-pays. This includes preparing and submitting notices of election and termination.
• Files documentation/paperwork in appropriate chart.

Payment Processing

• Tracks and posts payments and adjustments.
• Monitors account and analyze reports to track collections and meet goals.

Denial and Appeal Management

• Promptly follows up with each denial claim by investigating and resolving denied claims, to include but not limited to, researching issues and resubmitting them for payment or filing appeals as needed.
• Submits required documentation for each denied claim within the established timeframe.

Compliance

• Consistently maintains knowledge of changes and updates to Medicare regulations as it pertains to billing.
• Ensures confidentiality is always met and safeguards all patient related information.

Communication

• Displays a willingness to support Company and Medicare policiesand procedures and provides education to branches as needed.
• Maintains and accepts responsibility for regular attendance and punctuality.
• Serves as a resource on behalf of the billing department, to all employees of the Company.
• Performs other dutiesas assigned.

Qualifications & Skills:

• Minimum of two (2) years of experience in hospice billing, with current hands-on experience in hospice services.
• Demonstrated proficiency in medical billing software and electronic medical records (EMR) systems is required; experience with Consolo and Wellsky strongly preferred.
• Thorough knowledge of hospice billing practices, medical coding standards, and healthcare compliance regulations.
• Must be well organizedand demonstrate attentionto detail.
• Ability to work within a team environment and with deadlines.
• Strong communication skills, both oral and written with excellentinterpersonal skills.
• Proficient with a computerand Microsoft Word,Excel and Outlook software
• Ability to provide knowledgeand skills as it pertains to the billing process.
• Proficient knowledgeof intermediary billing policies and requirements.
• Must demonstrate good customer relations skills and a commitment to providing qualityservice.
• Acceptance and ability to demonstrate and support the core valuesand goals of Agency.

Education:

• High school diploma or GED required.

Working Conditions:

• Working environment is relatively quiet and can be stressful due to deadlines, multiple tasks and general compliance of law, rules and regulations. The position requiresvisual acuity and dexterity, sitting, standing, some pushing, pulling, and lifting up to twenty-five (25) pounds.

Compensation & Benefits:

• Hourly, 40 hours per week
• Paid Time Off (PTO) and Paid Holidays
• Comprehensive Full-Time Benefits: Medical, Dental, Vision, Life Insurance, Short- & Long-Term Disability, 401(k)
• Employee Referral Bonus Program

Job Tags

Similar Jobs