Hospice Medicaid Biller

Hospice Medicaid Biller

Requirements

• High School diploma or GED equivalent required.
• Associates Degree or sufficient on the job experience required.
• Knowledge of medical office accounting systems required.
• Proficient computer skills, with the ability to use Word and Excel required.
• Minimum of two years’ experience in healthcare billing and/or business office setting, preferably in Hospice.

Responsibilities

• Prepare and process patient related accounts payables and maintain check registers.
• Respond to vendor requests for information.
• Maintain current vendor demographics in Allscripts, and forward changes to HH A/P.
• Maintain files of approved/paid and denied invoices.
• Prepare Journal Entries for HH-Finance on an as needed basis.
• Process approved A/P Charity Requests and maintain permanent records.
• Prepare spreadsheets and reports as needed.
• Maintain knowledge of current CMS reimbursement rates.
• Responsible for gathering patient information and completing Medicaid Applications, to include screening, document review, follow-up and submission.
• Responsible for accounts receivable outcome. Processing electronic and manual remittance advices with appropriate adjustments. Balance daily posting, A/R follow-up on a daily basis.
• Assists with claim corrections of Medicare, Medicaid and Commercial payers. Timely and accurately.
• Maintains current knowledge of Hospice Benefit regulations.
• Maintains knowledge of department A/R policies and procedures.
• Prepares weekly collections reports for review with the Supervisor.
• Daily Medicaid Verifications and Admissions.
• The job involves processing, monitoring, and collecting claims in accordance with payer requirements, verifying billing data accuracy, and importing/posting payments from all payer types.
• Follows up on all denied, rejected and/or pending claims in a timely manner, utilizing all electronic means available.
• Initiates timely appeals and reconsiderations with payers by telephone, letter, email or other electronic media or spreadsheets.
• Evaluate and resolve accounts by utilizing resources including, but not limited to, bills, remittances, correspondence, worklists and insurance calls in accordance to payer specific guidelines in a timely manner.
• Reconcile nursing home room & board patient responsibility against Medicaid payments.
• Bi-Annually (January & July) research and system update of Room & Board Rate changes.
• Prepare and submit AHCA Complaints on payer claim denials as needed.
• Assist with Medicaid and Commercial Authorizations.
• Ensure account information is current by entering notes, documentation and changes at time of occurrence.
• Timely completion of Month End tasks.
• Review Medicaid program code changes for patients on our services.
• Serves as back-up for Medicare and Commercial Insurances. Completes assignments as requested.

Preferred Qualifications

• 2-3 years Finance experience preferred.
• Allscripts Homecare beneficial.