Palliative Care Billing Specialist

Hawaii Care Choices; Hilo (HI); On-site; USD 28,000 - 34,000; Full time

Job summary

Hawaii Care Choices is seeking a Billing & Coding Specialist for palliative care to manage claims submission, insurance verification, AR posting and denial follow-up. You will collaborate with the Intake and Accounting teams to ensure accurate pre-billing information and complete records.

Responsibilities include documentation review, compliance with HIPAA and payer policies, financial reporting, and patient account management.

Qualifications

• An associate’s degree in a related field.
• Two years palliative care billing experience preferred.
• Billing and/or coding certification preferred.
• Ability to use Excel and MS Office.
• Strong math and record-keeping skills.
• Knowledge of ICD-10, CPT, HCPCS and HIPAA.

Responsibilities

• Billing and Coding: Accurately process and submit palliative care claims to insurance companies, ensuring correct coding (ICD-10, CPT, HCPCS) and billing practices.
• Insurance Verification: Verify patient insurance coverage and benefits prior to services, ensuring eligibility for palliative care services.
• Claims Follow-Up: Monitor and follow up on denied or rejected claims, working to resolve issues and resubmit claims promptly.
• Patient Account Management: Manage patient accounts, including billing inquiries, payment processing, and addressing any discrepancies.
• Documentation Review: Ensure accurate and complete documentation for palliative care services, aligning with billing codes and regulations.
• Compliance: Maintain compliance with federal, state, and payer-specific regulations, including HIPAA, billing policies, and audit requirements.
• Financial Reporting: Prepare and submit regular financial reports detailing billing status, aging reports, and revenue cycle performance.
• Collaboration with Care Team: Communicate with healthcare providers and the care team to ensure proper documentation of palliative care services provided.
• Patient Advocacy: Assist patients and their families with understanding financial aspects of care, including payment options and insurance benefits.
• Training & Education: Stay up to date on billing codes, regulations, and industry trends, and provide guidance to staff on billing practices.
• Dispute Resolution: Resolve payment issues by negotiating with insurance companies, addressing underpayments, and identifying billing errors.

Skills

Self-motivated

Independent work

Math skills

Record keeping

Communication

Medical billing knowledge

Education

Associate degree

Tools

Excel

MS Office

Job description

Hawaii Care Choices is seeking a Billing & Coding Specialist for palliative care to manage claims submission, insurance verification, AR posting and denial follow-up. You will collaborate with the Intake and Accounting teams to ensure accurate pre-billing information and complete records.

Responsibilities include documentation review, compliance with HIPAA and payer policies, financial reporting, and patient account management.