Billing Representative – Hospice

This is a fully remote position, open to applicants in United States.

📋 Description

• Process and submit claims related to hospice services following Medicare, Medicaid, and payer billing guidelines.

• Submit claims with the necessary modifiers, including the GW modifier for unrelated services.

• Review claims for accuracy and completeness prior to billing.

• Verify payer information and billing requirements to ensure proper claim routing and reimbursement.

• Research, analyze, and resolve B9 denial claims effectively.

• Submit claims to the appropriate hospice payers for reimbursement.

• Document denial resolution efforts and payer communications within the billing system.

• Review correspondence, medical documentation, and supporting records to distinguish between related and unrelated hospice services.

• Collaborate with hospice providers and clinical staff to gather necessary documentation.

• Assign financial responsibility based on the outcomes of determinations.

• Ensure accurate and timely charges are reflected on client invoices for hospice facilities.

• Bill skilled nursing facilities when they hold financial responsibility for charges.

• Maintain timely bill-back activities and keep thorough notes on invoices.

• Keep accurate account notes, audit trails, and supporting documentation for billing and reimbursement functions.

• Assist internal and external audits by providing requested documentation and claim history records.

• Comply with CMS, HIPAA, Medicare, and organizational compliance standards.

• Collaborate with billing leadership, hospices, facilities, payers, Sales Teams, and internal departments.

• Uphold management-established standards for productivity, quality, and compliance.

• Support colleagues, share best practices, and help achieve departmental goals.

• Carry out other related duties and projects as assigned.

⛳️ Requirements

• High School Diploma or GED is mandatory.

• At least 2-3 years of experience in healthcare billing is required.

• Preferred experience includes Medicare claims processing, hospice payer billing, denial management, and reimbursement recovery.

• Experience working with skilled nursing facilities and hospice providers is favored.

• Hospice billing experience is advantageous but not essential.

• Strong understanding of Medicare hospice billing regulations and reimbursement guidelines is necessary.

• Familiarity with GW modifier requirements and hospice-related billing practices is important.

• Knowledge of B9 denial processing and claims resolution methods is required.

• Ability to interpret medical documentation and differentiate between related and unrelated hospice services.

• Deep understanding of healthcare billing and revenue cycle principles is essential.

• Knowledge of HIPAA, CMS regulations, and compliance requirements is crucial.

• Strong analytical, organizational, and problem-solving abilities are necessary.

• Excellent customer service and interpersonal skills are required.

• Ability to communicate professionally with both external and internal customers, hospice providers, skilled nursing facilities, clients, and Sales Teams is essential.

• Strong written and verbal communication skills are a must.

• Ability to collaborate across departments, support team initiatives, share knowledge, and foster a positive working atmosphere is essential.

• Capacity to build and sustain productive working relationships is important.

• Proficiency in billing systems, Microsoft Excel, Outlook, and other business applications is required.

• Ability to prioritize tasks and meet deadlines in a dynamic environment is essential.

🏝️ Benefits

• Remote work arrangement