Medical Billing Specialist - Home Health/Hospice

The Billing Specialist is responsible for the coordination of the Agency's billing functions in accordance with state, federal, and local regulations. Reports to the Director of Revenue Cycle.
Building Excellence Through Empowered Employees!
What Can Traditions Health Offer?

• PHENOMENAL PTO- -Starting Day 1!!!
• Competitive Salary
• Supportive Leadership
• Career Growth opportunities
• Training Environment
• Work/Life Balance

Education: High school diploma or equivalent
Knowledge and Skills:

• Must be able to read and write in English and follow instruction
• Knowledge of office machines, excellent computer skills, proficient in Microsoft Office Software, excellent interpersonal and organizational skills
• Knowledge of billing and CMS regulations.

Transportation: Reliable transportation and valid and current auto insurance.
Environmental and Working Conditions:
Works in a routine office environment. Noise level may be moderately high, ability to work a flexible schedule and extended hours. Ability to travel locally and some exposure to inclement weather. Possible exposure to toxic materials, toner, etc.
Physical and Mental Effort:
Prolonged sitting and some standing required. Occasional need to lift, pull, carry and push items weighing up to fifty pounds. Requires working under some stressful conditions to meet deadlines. Requires the potential facilitating of patient/family individualized needs under time constraints. Requires hand-eye coordination and manual dexterity. Required problem solving skills.
Essential Functions:

• Effectively demonstrates the mission, vision and values of the agency on a daily basis.
• Ensures all documents are in order and submitted timely according to Medicare and Palmetto standards. Responsible for the coordination of billing though billing company.
• Responsible for HIS Submission for hospice branches. Ensures timely and accurate submission.
• Ensure NOEs are submitted within allotted timeframe (5 days following hospice admission). Follow-up with BlackTree for any discrepancies with report
• Collaborates with the management team to develop and implement plans to ensure billing functions are aligned with company goals
• Responsible for completing medical record request for audit review from payor sources, to include private insurance, Medicaid and Medicare
• Responsible for OASIS Submission for home health branches. Ensures timely and accurate submission.
• Establish and maintain effective communication within and between branches and with Nursing Home Facilities.
• Responsible Respite Billing, as determined by Company process
• Responsible for Hospice Room and Board billing process, to include creating Medicaid Room and Board claim, submission of appropriate forms, authorization, and monitoring for pending authorization (expiring authorization)
• Responsible for Nursing Home payables to include verification of previously billed Medicaid claims to ensure timely payment, verification of RUG level rates to ensure proper payment
• Follows up on denied, under and over paid claims, when applicable.
• Completes HCHB Billing Specialist workflow in timely manner
• Responsible for the creation and invoicing of private pay patients for Hospice
• Ensure compliance with local, state and federal regulations and the agency's policies and procedures
• Other tasks as assigned by management

Equal Employment Opportunity:
Traditions Health is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination of any kind based on race, color, sexual orientation, national origin, disability, genetic information, pregnancy or any other legally protected characteristic.