Senior Billing Manager - Healthcare/Homehealth-Hospice

The Billing Manager is responsible for the coordination of billing functions in
accordance with state, federal, and local regulations. Reports to the Senior Director of Revenue Cycle.
What Can Traditions Health Offer?

• Competitive Pay
• Great Benefits -- Very Generous PTO Structure from Day 1!
• Supportive Leadership
• Career Growth opportunities
• Training Environment
• Work/Life Balance

Education: High school diploma or equivalent
Licensure: Current driver's license
Experience: At least three years of experience is preferred, working in a health care related industry.
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.
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, Palmetto and/or payor standards. Responsible for the coordination of billing through third party billing company.
  • Responsible for HIS Submission. Ensures timely and accurate submission.
  • Ensure NOEs are submitted within allotted timeframe (5 days following hospice admission). Follow-up with third party billing company for any discrepancies.
  • Collaborates with the branch management and office support staff to develop and implement plans to ensure billing functions are aligned with company goals.
  • Obtain new authorization for state Medicaid patients (monthly)
  • Responsible for insurance verification (eligibility) and coordination of billing functions for overlapping benefit periods.
  • Establish and maintain effective communication with internal and external customers including branch offices, nursing home facilities, hospitals and other vendors.
  • Responsible for the oversite of respite billing, as determined by Company process.
  • Responsible for Hospice Room and Board billing process, to include creating state Medicaid Room and Board claim, submission of appropriate forms, authorization, and monitoring for pending authorization (expiring authorization).
  • Responsible for the oversite of the division's Nursing Home payables to include, verification of previously billed Medicaid claims, and verification of RUG level rates to ensure proper payment. Ensure timely payment of facility claims.
  • Follow up on EOB and refund requests to ensure denied, under, and over paid claims are billed in accordance with state and federal regulation.
  • Completes HCHB Billing Specialist workflow in timely manner
  • Responsible for the creation and invoicing of palliative care patients
  • 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.
Traditions Health Mandatory COVID-19 Vaccine Policy:
Pursuant to the CMS Omnibus COVID-19 Health Care Staff Vaccination Final Rule effective February 14, 2022 Traditions Health is required to have policies and procedures in place to ensure all facility staff, regardless of clinical responsibility or resident contact (Home health and hospice employees, Licensed practitioners, Students, trainees, and volunteers; and Individuals who provide care, treatment, or other services for the home health and hospice and/or its patients, under contract or by other arrangement), are either fully vaccinated against COVID-19 or have been granted a qualifying religious or medical exemption. All applicants to whom an offer of employment is made, shall be required, as a condition of employment, to either be fully vaccinated by their start date, or approved for a medical or religious exemption. The policies and procedures specified do not apply to staff who exclusively provide telehealth or telemedicine services, and staff who provide support services for the home health and hospice agencies that are performed exclusively outside of the settings where home health and hospice services are directly provided to patients and who do not have any direct contact with patients, families, and caregivers, and other staff. For questions related to this policy, please contact our talent acquisition team.