Hospice Billing Analyst I
Graham Healthcare GroupResponsibilities
SUMMARY
Support the Team Lead and Billing Supervisor to ensure timely and correct claims are filed with all respective payers and intermediaries for Hospice patients. Monitor claims for timely processing of payments and rejections and work on Accounts Receivable (A/R) weekly.
HOSPICE BILLING ANALYST ESSENTIAL DUTIES AND RESPONSIBILITIES
- Bill for Medicare/Medicaid/Blue Cross and other commercial payors under Hospice guidelines
- Complete/update room & board admissions/discharges in CHAMPS, Medi System
- Complete Illinois Medicaid & Managed Medicaid Enrollments/Discharges and submit to the State of Illinois
- Obtain Medicaid rate letters from facilities when rates are updated
- Update room and board rates in HCHB as required
- Process workflow in HCHB to set up room and board
- Develop and maintain relationships with skilled nursing facilities (SNF)
- Complete and submit HPF form to SNF within 24 hours of admission
- Manage monthly Medicaid billing for SNFs
- Communicate directly with Sales Team when SNF invoice payments are being held
- Monitor monthly Medicaid eligibility and maintain PPA updates
- Review unbilled reports for Medicaid and commercial room and board claims weekly
- Review Blue Cross 5th Level Claims in web-DENIS for payment dates
- Create and review room and board/respite invoices for accuracy
- Submit reviewed room and board/respite invoices to SNF for their review, obtain signatures, and correct any discrepancies
- Submit room and board invoices to AP, adhering to deadline date
- Review revenue and expenses related to room and board to ensure that payments sent to facilities tie to the payments received by the insurance carrier and the accounting system
- Update billing notes and follow up as required
- Review all payor remits filed in OneDrive by Accounts Payable
- Prepare and submit write-off/bad debt documentation to Hospice Billing Manager by monthly deadline for Revenue Cycle
- Work closely with AP department to resolve payment issue
- Perform claims adjustment/correction in CHAMPS, Medi, Waystar, web-DENSI, and commercial payor web portals
HOSPICE BILLING ANALYST QUALIFICATION REQUIREMENTS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- High School education or equivalent
- Minimum of one (1) year billing experience in the Hospice or Home Health industry
- Medicare FISS (Fiscal Intermediary Standard System)/DDE (Direct Data Entry) and CHAMPS experience preferred
- Experience using clinical billing software and electronic claims submission
- Knowledge of Hospice Medicare/Medicaid compliance
- Strong computer knowledge
- Experience navigating a computer network
- Proficient in Microsoft Office
- Experience using web-DENIS
- Experience using Commercial billing software/websites
- Demonstrate patience, flexibility, and cooperative attitude
- Conscientious with attention to detail
- Ability to multitask and work independently
- Excellent communication and organizational skills, verbal and written
CERTIFICATES, LICENSES, REGISTRATIONS
Must have and maintain in good standing professional license, certificate, or registration, as applicable.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.
COMMENTS
This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.
About Graham Healthcare Group:
As an innovator in an evolving healthcare world, Graham Healthcare Group has been designing business and technology solutions to drive better care, outcomes, and productivity within its own home health and hospice companies for over 20 years. In the last several years, our solutions have been successfully integrated across the healthcare continuum.
Join the Graham Healthcare Group and enjoy the following benefits:
- Competitive Pay: With opportunity for advancement
- Health and Welfare Benefits: Various medical, dental, and vision insurance options for you and your family to choose from.
- Supplemental Benefits: Company paid life insurance and disability benefits. Also, pre-tax FSA and HSA plans are offered.
- Generous PTO Packages.
- Retirement: Save for your future with our company offered 401k plan and pension.
- Company-Paid Education Programs: Grow your career by taking advantage of 50% discounts on tuition for selected courses offered by Purdue and Kaplan.
Benefits may vary based on your employment status.
NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.
By supplying your phone number, you agree to receive communication via phone or text.
By submitting your application, you are confirming that you are legally authorized to work in the United States.
JR# JR247267
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