Billing Specialist

Montgomery Hospice, Inc.; Rockville (MD); Hybrid; USD 42,000 - 66,000; Full time

Job summary

Montgomery Hospice, Inc. in Rockville, MD seeks a Biller to manage all hospice account activities including billing, collections, claims, posting and appeals.

You will communicate with patients, caregivers, insurers and clinical staff to determine eligibility, generate invoices and collect payments for services. Requirements include a high school diploma, 2 years of Medicare/commercial billing experience, and proficiency with UB04, CMS-1500 and MS Office tools.

Qualifications

• High School Diploma or equivalent; Associate degree preferred.
• Minimum of two years’ experience with Medicare, commercial billing, posting and collections.
• Ability to understand payer contract language and compliance requirements.

Responsibilities

• Manages all aspects of patient account activities.
• Maintains effective communication with patients, caregivers, insurers, and staff.
• Performs pre-billing functions to ensure claims are ready for submission.
• Submits claims in a timely manner to payers.
• Reviews initial claim denials and resubmits with corrections.
• Monitors billing cycles and payer rates for accuracy.
• Maintains patient data in the EMR for accurate billing status.
• Keeps informed of Medicare, Medicaid, and commercial payer requirements.
• Handles payer inquiries and follows up until issues are resolved.
• Monitors accounts receivable aging and follow-up dates with payers.

Skills

Verbal communication

Education

High School Diploma or equivalent

Associate degree or higher preferred

Tools

UB04

CMS-1500

Clearing houses

Microsoft Word

Microsoft Excel

Microsoft Teams

Zoom

Job description

The Biller is responsible for all aspects of Hospice and palliative account activities, including billing, collections, claims, payment posting and appeals. They communicate with patients, caregivers, insurance providers, physician practices, administrative and clinical staff to determine eligibility, generate invoices, and collect payment for services provided by Hospice.

Duties and Responsibilities:

• Manages all aspects of patient account activities.
• Maintains effective communication with patients, caregivers, insurance providers, and) staff regarding billing procedures and eligibility for services.
• Performs any pre-billing functions necessary to ensure claims are ready for submission to the payer.
• Submits claims in a timely manner to the payer.
• Reviews initial claim/ batch of rejection notices and re-submit claims with corrections to the respective payers.
• Monitor billing cycles to ensure proper rates are in effect.
• Maintains and updates patients' data in the EMR system to affirm accurate and adequate data is maintained in files concerning patients' billing status.
• Keeps informed of Medicare, Medicaid, and commercial insurance regulations to ensure all billing activity is kept in compliance with current insurance policies.
• Handles insurance inquires and requests from payer sources and follows up on initial contact until issues or claims are settled.
• Must attend Finance Department meetings and other meetings when required.
• Monitors appropriate hospice patients' ongoing claim status.
• Reviews outstanding balances over 30 working days with follow up to payer source for expected payment and release date.
• Monitors time interval between claim filings submission, and receipt of claim payments.
• Prepares monthly aging of accounts receivable to assist management with pertinent data related to cash flow.
• Maintains scheduled billing cycles for patients' accounts.
• Maintains supporting documentation and detailed notes in patients' billing files.
• Meets requirements for educational growth and development.
• Efficiently utilizes computer systems and various remote telecommunication platforms to increase productivity and effectiveness.
• Continually assesses their own skill and knowledge base and actively seeks additional training through available resources.
• Comes to meetings prepared to discuss pertinent issues.
• Receives, evaluates, and discusses criticism in a professional manner.
• Keeps abreast of current issues pertinent to the profession.
• All other duties as assigned.

Minimum Qualifications:

• Education: High School Diploma or equivalent required. Associates degree or higher preferred.
• Experience: Minimum of two years of experience with Medicare, commercial billing, payment positing and collections.
• Must possess the ability to understand and communicate with payer contract language.
• Demonstrated understanding of Medicare, Medicaid, and Commercial payer requirements.
• Knowledge of medical billing systems UB04, CMS-1500, and clearing houses – hospice and Medicare experience preferred.
• Proficient in Microsoft Word, Microsoft Excel, and telecommunication tools such as Microsoft Teams and Zoom.
• Excellent verbal and written communication skills and ability to communicate with internal and external stakeholders.
• Must be dependable and self-reliant.

EEO Statement: Montgomery & Prince George's Hospice is an equal opportunity employer and always employs qualified individuals based on job-related qualifications without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, and protected veteran or disability status.