SUMMARY
Responsible forproviding billing and collections functions in accordance with current federal, state and local regulations that govern hospice agencies.
ESSENTIAL DUTIES AND RESPONSIBILITES include the following.
Other duties may beassigned .
Assist in processing monthly hospice billing/charges to the appropriate pay sources and responsible parties each month for the previous month ' s chargesAssist in processing daily hospice billing / charges to the appropriate pay sources and responsible parties Oversees process for visit authorizations for private insurance patients, including reconciliation of the actual visits done vs. what was initially authorized and communicate the variance to the appropriate personsCommunicates with patients, clients , responsible parties, insurance companies, Medicare, Medicaid, billingcompany and others in order to collect outstanding receivables dueDemonstrate knowledge and compliance with rules and regulations regarding Medicare, Medicaid and private insurance s Research accounts receivable open items , denial , partial payments on a monthly basis and take necessary measures to collect monies due from appropriate sourcesDevelop workingrelationships with hospice associates regarding accurate data entry to ensure clean claim submission including but not limited to communication with leadership, office staff and cliniciansProcesses and analyzes claims reports on a daily basis identifying exceptions and working collaboratively to reconcile and resolve all outstanding issuesOversees process for hospice admissions including verification of benefits , accuracy of initial data entry, pre-certification and/or authorization for servicesCommunicates RT P 's to appropriate persons and resolves these in collaboration with the associates of the respective organizationsWork with administrators to insure systems are updated as needed to reflect appropriate codes, charges, pay sources and accounts receivable to ensure compliance and correct billing Establish systems for the orderly receipt of remittance advices, explanation of benefits and responsible party paymentsConsult with administrators and operations concerning billing & collections department to assist in eliminating / correcting problem areas and / or improving processesComply with the organization 's Compliance, Privacy & Security programsPromotes the image and reputation ofthe System by exhibiting servant leadership and providing direct and open linesof communicationContributes to the work of committees,workgroups, project management, and other collaborative efforts of the SystemPerforms otherduties as necessary to ensure the success of the System SKILLS AND ABILITY
Ability to utilize and master the billingsoftware programs.
Knowledge of financial management and organizational concepts.
Ability to effectively communicate and present information in a clear and concise manner both oral and written.
Ability to understand, communicate and respond appropriately in regards to basic medical terminology.
Must be willing to attend educational meetings and conferences , including webinars and teleconferences to learn new rules and regulations pertaining to coding and billing.
MINIMUM QUALIFICATIONS
A high school diploma is required with a minimum of two (2) years of experience in homehealth billing and collections.
COMPUTER APPLICATION SKILLS
This job requires initial proficiency with the following computer applications including but not limited to:
Microsoft Outlook Microsoft Excel Microsoft Word Electronic Health Record
EEO / M/ F/ D/ V/ Drug-Free Workplace