Billing and Outside Claims Specialist

Four Seasons; Flat Rock (NC); On-site; USD 25,000 - 36,000; Full time

Benefits offered by this job

Competitive salaries

Annual bonus opportunities

Medical insurance with zero premiums

Tuition reimbursement

Job summary

Four Seasons in Flat Rock, NC is seeking a detail‑oriented Billing and Outside Claims Specialist to manage timely collection of hospice and palliative patient accounts. You will handle data entry for the Billing Department while delivering excellent customer service to patients, families and staff.

The role requires knowledge of Medicare/Private Insurance billing, proficiency with CareCloud or Suncoast, and a collaborative approach within a cross-functional Billing Team to meet monthly and

Qualifications

• Knowledge of HIPAA privacy policies.
• Excellent organization skills.
• Excellent written, oral, and collaborative communication skills.
• Excellent interpersonal skills.

Responsibilities

• Process patient statements for Palliative Care.
• Post payments and adjustments in billing software.
• Support Billing Team during high-volume periods.
• Respond to patient inquiries and resolve billing questions.
• Audit tracker records and maintain documentation.
• Verify patient eligibility and benefits as needed.
• Bill all hospice and palliative care claims to Medicare/Medicaid/Private Insurance.
• Maintain confidentiality and adhere to organizational values.

Skills

HIPAA knowledge

Communication skills

Organizational skills

Team collaboration

Education

Associate's degree in Healthcare or Business

Tools

Suncoast Billing System

CareCloud

MS Excel

Job description

Our Accolades.

Benefits

• Competitive Salaries, Reviewed Annually
• Annual Operational Performance Bonus Opportunities
• $0 Employee Premiums on Medical Insurance
• Annual $600 Well-Care Benefit Towards Self-Care, Childcare, Pet Care, or Elder Care
• Medical & Dental Insurance Benefits First of the Month after Hire
• 403B Retirement Plan with Employer Match
• Generous Paid Time Off Package: 20+ Days of PTO Per Year
• Up to 6 Paid Holidays
• Employer Paid STD, LTD, & Life Insurance
• Employer Paid Teletherapy & Telemedicine Coverage
• Health & Dependent Care Flexible Spending Accounts
• A Robust Employee Wellness Program
• Up to $3k in Tuition Reimbursement Each Year

Our Accolades.

Four Seasons is proud to have been named one of Modern Healthcare’s Best Places to Work, and to have been Living Wage Certified in Western North Carolina . Our approach to providing not only excellent care to our patients and families, but also providing the same heartfelt care and commitment to our employees, leads us to be recognized as not only a leader in hospice and palliative care, but also a beacon of excellence as an employer in Western North Carolina.

Benefits

Our Benefits.

Four Seasons offers an excellent benefits package for both full time and part time eligible employees, which may include:

• Competitive Salaries, Reviewed Annually
• Annual Operational Performance Bonus Opportunities
• $0 Employee Premiums on Medical Insurance
• Annual $600 Well-Care Benefit Towards Self-Care, Childcare, Pet Care, or Elder Care
• Medical & Dental Insurance Benefits First of the Month after Hire
• 403B Retirement Plan with Employer Match
• Generous Paid Time Off Package: 20+ Days of PTO Per Year
• Up to 6 Paid Holidays
• Employer Paid STD, LTD, & Life Insurance
• Employer Paid Teletherapy & Telemedicine Coverage
• Health & Dependent Care Flexible Spending Accounts
• A Robust Employee Wellness Program
• Up to $3k in Tuition Reimbursement Each Year

Billing and Outside Claims Specialist

Reports To

Director of Billing

Status

Full time, Hourly (Non-exempt)

Shift

Monday-Friday, 8:00am - 4:30pm

Location

Flat Rock, NC

Position Summary

This position is responsible for the accurate, timely and effective collection of all hospice and palliative patient accounts. Duties will also include data entry needs of the Billing Department while demonstrating excellent customer service with both internal and external customers. The Specialist must exhibit the technical competency, work ethic, attitude, discipline and communications skills required by Four Seasons to attain specified monthly, quarterly and fiscal year goals, and to work as part of a cohesive Billing Team.

Essential Duties & Responsibilities

• Process Palliative Care patient statements
• Perform Palliative Care cash posting
• Assist Billing Team with tasks/responsibilities during times of high volume and cover areas needed while others are on PTO
• Communicate effectively with Billing Team members and other department staff members related to billing needs
• Serve as a resource and respond to patient accounting and billing questions from patients, responsible parties, staff, and all reimbursement sources
• Assist with Tracker Auditing
• Maintain adequate documentation related to patient account data
• Verify benefits and completes patient eligibility, as needed
• Billing of all claims for hospice and palliative care services to Medicare, Medicaid, Private Insurance and Private Pay using practice management system and other billing software tools as needed
• Post payments and adjustments into patient accounts software as needed
• Demonstrate excellent communications and customer service skills with patients, families, staff & vendors
• Adhere to confidentiality regarding patients, families, staff and the organization
• Other duties as assigned

Knowledge, Skills & Abilities

• Knowledge of HIPAA privacy policies
• Excellent organization skills
• Excellent written, oral, and collaborative communication skills
• Excellent interpersonal skills
• Excellent attention to detail and accuracy
• Proficient in MS Office: Outlook, Word, Excel, etc.
• Ability to work independently with minimum supervision
• Ability to work under pressure to meet deadlines
• Ability to take initiative and utilize innovative techniques
• Ability to interact with various departments throughout the organization
• Ability to participate as a team player
• Ability to plan, prioritize and coordinate daily tasks
• Honor, exhibit and respect the organizational values of: Compassion, Balance, Respect, Integrity, Teamwork, and Excellence
• Perform other duties as requested by Billing Manager

Education

Minimum Qualifications:

• Associate’s degree in Healthcare, Business, or equivalent experience in a related field
• Continuing education or professional development related to healthcare billing and administration, preferred

Experience

• Experience with Medicare Part A & B billing, Private Insurance, Private Pay preferred
• Experience with computerized medical billing systems; Suncoast and/or Carecloud experience preferred

Licensures & Certifications: (if applicable)

• Certified Professional Coder, preferred

Summary Of Physical Requirements