Hospice Medicare Billing and Collections Representative

Qualifications:

• High School Diploma or GED
• Minimum of one (1) year of medical billing and collection experience
• Knowledge of third party billing and state and federal collection regulations preferred
• Ability to prioritize and multi-task independently with little supervision
• Must be self-motivated and service oriented
• Excellent written and verbal communication skills
• Accurate typing and data entry skills

Competencies:

• Satisfactorily complete competency requirements for this position.

Responsibilities of all employees:

• Represent the Company professionally at all times through care delivered and/or services provided to all clients.
• Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse.
• Comply with Company policies, procedures and standard practices.
• Observe the Company's health, safety and security practices.
• Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company.
• Use resources in a fiscally responsible manner.
• Promote the Company through participation in community and professional organizations.
• Participate proactively in improving performance at the organizational, departmental and individual levels.
• Improve own professional knowledge and skill level.
• Advance electronic media skills.
• Support Company research and educational activities.
• Share expertise with co-workers both formally and informally.
• Participate in Quality Assessment and Performance Improvement activities as appropriate for the position.

Job Responsibilities:

• Prepares and submits accurate billing to third party payor’s and self-pay invoices.
• Identifies and resolves billing clearinghouse rejections.
• Conducts root cause analysis on unpaid accounts receivable (AR) and resolves with third party payor’s.
• Analyzes and resolves credit balances.
• Handles incoming and outgoing customer service calls to third party payor’s, outside providers and patients/guarantors to resolve and achieve account resolution.
• Processes correspondence.
• Initiates and resolves technical denial appeals.
• Identifies payor denial and cash fluctuation trends and escalates as appropriate.
• Performs other duties as assigned.