Billing Specialist Ii

Position: BILLING SPECIALIST II
Job Summary:

Under the direction of the Director of Revenue Cycle, responsible for all aspect of billing and collections for all pay sources, following all compliance and regulatory requirements. Completes all billing workflow in an efficient and timely manner.

Job Duties:

Keep in compliance of regulatory compliance requirements related to billing.

Completes workflow in the EHR system for verification, eligibility and authorizations

Reviews and processes the coordination workflow and completes action items

Performs all billing functions, daily, weekly and monthly. (Medicare, Medicaid, third party, self-pay, Hospice Verifies all Medicaid patients’ eligibility on the first of each month.

Initiates Travel Patient Agreements and Authorization for Services that are identified in the workflow

Initiates Authorization for Services that are identified in the workflow

Reviews patient account balances for credits and process refunds if appropriate

Participates in monthly aging meeting with CFO and Director of Revenue Cycle Participates in weekly team meeting

Participates in weekly 1:1 meetings

Compose and mail out benefit summary letters (Commercial Insurance, Medicaid, and Self Pay)
Send notifications of hospice admission and/or deaths to DCFProcess Medicaid applications and follow up on additional information requests from DCF to process the application

Check status regularly of Medicaid applications in process and inform patient’s Social Worker of status including any new information required

Notifies contracted hospitals when a patient chooses Hospice while in their hospital

Notifies contracted Nursing Facility when a resident at their location as chosen admission to Hospice Care and when patient is discharged from Avow.

Participates in monthly aging meeting with CFO and Director of Patient Accounts Field phone calls from outside vendors, patients/families, etc. and assist with billing concerns

Maintains and reviews, as necessary, the billing system for Hospice, including patient’s accounts payable and receivable.

Bills related software, such as Medicaid Portal for Medicaid and on-line services available for Medicare.

Manages and coordinates billing and collection functions for programs as assigned

Collections follow up per procedure.

Maintains current information on Medicare and Medicaid and prepare required reports.

Works together with team and other organizational departments to ensure that the needs of patients are being met in relation to billing and authorizations.

Other duties as assigned by the Director or CFO.Core Values:

Innovation:

We embrace change and are always looking at creative ways to solve problems and serve new populations.

Integrity:

We are honest, hardworking, fiscally responsible professionals driven solely by the well-being of our patients, their loved ones, and the communities we serve.

Collaboration:

We know we cannot achieve everything we want without working hand-in-hand with each other, with our healthcare partners, and with the community.

Celebration:
We believe in the importance of celebrating life and relationships.

Education:

We believe it is important not only to serve the community but to educate community members about our services and the role we can play at the end of life.

Education and / or

Experience:

Bachelor's Degree (B.A.) or equivalent from four-year college or technical school; or two to five years of related experience and/or training; or equivalent combination of education and experience.

Certificates, Licenses, Registrations:

Current Driver’s License.

Computer

Skills:

Experienced in hospice and/or healthcare billing software; word processing software; spreadsheets and general computer usage.

Mathematical

Skills:

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

Language

Skills:

Ability to read, analyze, and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports, business correspondence. Ability to effectively present information and respond to questions from groups…