Hospice Billing Analyst I

Graham Healthcare Group; United States; Remote; USD 45,000 - 60,000; Full time

Job summary

A leading healthcare solutions provider is seeking a Hospice Billing Analyst to support timely claims processing and billing for Medicare, Medicaid, and commercial payors. The role involves close collaboration with various teams to ensure accurate billing and compliance with regulations. Ideal candidates will have strong communication skills, attention to detail, and experience in billing within the hospice or home health sector. Competitive pay and benefits are offered, including health insurance and generous PTO.

Benefits

Competitive pay

Health, dental, vision insurance options

Company-paid life and disability insurance

Generous PTO

401k

Educational discounts

Qualifications

• At least one year of billing experience in Hospice or Home Health.
• Experience with Medicare FISS/DDE preferred.

Responsibilities

• Bill for Medicare/Medicaid/Blue Cross under Hospice guidelines.
• Manage monthly Medicaid billing for skilled nursing facilities.
• Review unbilled reports for Medicaid and commercial claims weekly.

Skills

Communication

Attention to Detail

Multitasking

Education

High School diploma or equivalent

Tools

CHAMPS

web-DENIS

clinical billing software

Job description

SUMMARY

Support the Team Lead and Billing Supervisor to ensure timely and correct claims are filed with all respective payers and intermediaries for Hospice patients. Monitor claims for timely processing of payments and rejections and work on Accounts Receivable (A/R) weekly.

HOSPICE BILLING ANALYST ESSENTIAL DUTIES AND RESPONSIBILITIES

• Bill for Medicare/Medicaid/Blue Cross and other commercial payors under Hospice guidelines
• Complete/update room & board admissions/discharges in CHAMPS, Medi System
• Complete Illinois Medicaid & Managed Medicaid Enrollments/Discharges and submit to the State of Illinois
• Obtain Medicaid rate letters from facilities when rates are updated
• Update room and board rates in HCHB as required
• Process workflow in HCHB to set up room and board
• Develop and maintain relationships with skilled nursing facilities (SNF)
• Complete and submit HPF form to SNF within 24 hours of admission
• Manage monthly Medicaid billing for SNFs
• Communicate directly with Sales Team when SNF invoice payments are being held
• Monitor monthly Medicaid eligibility and maintain PPA updates
• Review unbilled reports for Medicaid and commercial room and board claims weekly
• Review Blue Cross 5th Level Claims in web-DENIS for payment dates
• Create and review room and board/respite invoices for accuracy
• Submit reviewed room and board/respite invoices to SNF for their review, obtain signatures, and correct any discrepancies
• Submit room and board invoices to Accounts Payable, adhering to deadlines
• Review revenue and expenses related to room and board to ensure payments sent to facilities match insurance payments and accounting records
• Update billing notes and follow up as required
• Review all payor remits filed in OneDrive by Accounts Payable
• Prepare and submit write-off/bad debt documentation to Hospice Billing Manager monthly
• Work closely with Accounts Payable to resolve payment issues

QUALIFICATIONS AND REQUIREMENTS

• High School diploma or equivalent
• At least one year of billing experience in Hospice or Home Health
• Experience with Medicare FISS/DDE and CHAMPS preferred
• Experience with clinical billing software and electronic claims submission
• Knowledge of Hospice Medicare/Medicaid compliance
• Strong computer skills and experience with web-DENIS and commercial billing software
• Patience, flexibility, attention to detail, and ability to multitask and work independently
• Excellent communication and organizational skills, both verbal and written

CERTIFICATES, LICENSES, REGISTRATIONS

Must maintain any required professional licenses, certificates, or registrations in good standing.

PHYSICAL DEMANDS

Regularly talk, hear, stand, walk, sit, climb stairs, handle objects, reach, and occasionally lift up to 20 pounds. Vision requirements include close vision and focus adjustment.

WORK ENVIRONMENT

Primarily an office setting with standard office equipment. May involve travel and exposure to weather conditions.

COMMENTS

This description covers essential functions and general responsibilities but is not exhaustive. Duties may change as needed.

About Graham Healthcare Group

Innovator in healthcare solutions for over 20 years, integrating services across the healthcare continuum.

Benefits

• Competitive pay and opportunities for advancement
• Health, dental, vision insurance options
• Company-paid life and disability insurance, FSA, HSA
• Generous PTO, 401k, pension
• Educational discounts and programs

Benefits vary by employment status.

Notice

Includes drug screening, and consent to communication and work authorization confirmation.

Job reference: JR# JR247267