Billing and Outside Claims Specialist

Sterling Home Health, Llc; North Carolina; On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Medical Insurance

Retirement Plan

Paid Time Off

Tuition Reimbursement

Life Insurance

Teletherapy & Telemedicine

Flexible Spending Accounts

Job summary

Four Seasons is seeking a Billing and Outside Claims Specialist in Flat Rock, NC to ensure accurate, timely hospice and palliative patient billing, and data entry for the Billing Department with excellent customer service.

The role requires processing statements, cash postings, and supporting the Billing Team during peak periods while maintaining confidentiality and professional interactions with patients and staff.

Qualifications

• Associate’s degree in Healthcare, Business, or related field is required or equivalent 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.
• Certified Professional Coder, preferred.

Responsibilities

• Process Palliative Care patient statements.
• Perform Palliative Care cash posting.
• Assist Billing Team with tasks during high volume and PTO coverage.
• Communicate effectively with Billing Team and other staff on billing needs.
• Respond to patient accounting and billing questions from patients and others.
• Maintain documentation related to patient account data.
• Verify benefits and patient eligibility as needed.
• Billing of all hospice and palliative care claims to Medicare, Medicaid, private insurance and private pay.
• Post payments and adjustments into patient accounts software.
• Demonstrate strong customer service and confidentiality.
• Other duties as assigned.

Skills

HIPAA policies

Communication

Attention to detail

Independent work

Deadline oriented

Team collaboration

Organization

Education

Associate’s degree in Healthcare, Business, or related field

Continuing education related to healthcare billing

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

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:

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

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 pounds
• Specific 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.

JOB DESCRIPTIONS ARE NOT INTENDED AS AND DO NOT CREATE EMPLOYMENT CONTRACTS. THE ORGANIZATION MAINTAINS ITS STATUS AS AN AT-WILL EMPLOYER.