Billing and Outside Claims Specialist

Four Seasons, The Care You Trust

Flat Rock (NC)

On-site

USD 28,000 - 39,000

Full time

3 days ago

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Benefits offered by this job

Competitive Salaries

Annual Performance Bonus

$0 Employee Premiums on Medical

Well-Care Benefit $600/yr

Medical & Dental Insurance First of Mo

403B with Employer Match

PTO 20+ days/yr

Up to 6 Paid Holidays

Employer Paid STD, LTD & Life

Teletherapy & Telemedicine Coverage

Flexible Spending Accounts

Tuition Reimbursement

Job summary

Four Seasons is seeking a Billing and Outside Claims Specialist in Flat Rock, NC to accurately and efficiently manage hospice and palliative patient accounts. You will post payments, verify benefits, and support the Billing Team while maintaining excellent customer service to internal and external stakeholders.

The role requires attention to detail, HIPAA compliance, and the ability to work under pressure to meet monthly and fiscal targets.

Qualifications

Education in healthcare billing or related field.
Experience with Medicare Part A & B billing or Private Insurance preferred.
Certified Professional Coder preferred.

Responsibilities

Process Palliative Care patient statements.
Post payments and adjustments in patient accounts software.
Assist Billing Team during high volume periods.
Respond to patient accounting and billing questions.
Verify benefits and patient eligibility as needed.
Bill hospice and palliative care services to Medicare, Medicaid, private insurance and private pay.
Adhere to confidentiality and data privacy.

Skills

HIPAA policies

Communication

Attention to detail

Independence

Prioritization

Teamwork

Deadline management

Confidentiality

Education

Associate’s degree in Healthcare or Business

Professional development in billing/administration

Tools

Suncoast

CareCloud

Job description

Billing Regular Full-Time Non-Clinical Admin Flat Rock, NC, US

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
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.

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 written, oral, and collaborative communication skills
Excellent interpersonal skills
Excellent attention to detail and accuracy
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

Minimum Qualifications:

Education:

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:

Ability to sit for prolonged periods of time; in excess of four hours per day
Constant use of hands to finger, handling, or feeling; reach with hands and arms; and talk; or hear
Ability to occasionally lift and/or move up to 10 poundsSpecific vision abilities required are close vision and distance vision with the ability to adjust focus, as needed

Intent & Function:

All descriptions have been reviewed to ensure that only essential functions and basic duties have been included. Peripheral tasks, only incidentally related to each position, have been excluded. Requirements, skills, and abilities included have been determined to be the minimal standards required to successfully perform the duties of the position. In no instance, however, should the duties, responsibilities, and requirements delineated be interpreted as all-inclusive. Additional functions and requirements may be assigned as deemed appropriate.

In accordance with the Americans with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals.

Position Summary:

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