Billing & Collections Specialist

CEDAR VALLEY HOSPICE INC•Waterloo, IA

2d•Onsite

About The Position

Join Cedar Valley Hospice, a trusted not-for-profit organization with multiple local and national awards for high-quality, exceptional end-of-life care, including the area’s only 5-star hospice for patient care (awarded by Medicare.gov). As a Billing & Collections Specialist, you’ll work collaboratively with Admissions as well as the Clinical teams to support accurate documentation, timely reimbursement, and the financial operations of Cedar Valley Hospice. You’ll be responsible for coordinating daily revenue cycle activities which include hospice billing, accounts receivable management, payer follow-up, claim resolution, reimbursement activities, and revenue cycle reporting. Cedar Valley Hospice’s “One Team, One Mission” mentality means we support each other and that every Cedar Valley Hospice employee plays a vital role in our organization’s story. We are the premier hospice provider serving 15 counties with offices in Waterloo, Grundy Center, Independence and Waverly, and are committed to helping patients live fully and comfortably wherever they call home.

Requirements

Associate’s degree required.
Minimum of two years of healthcare billing, accounts receivable, or revenue cycle experience preferred.
Experience with Medicare hospice billing, Medicaid, managed care organizations, commercial insurance, and third-party reimbursement preferred.
Prior hospice, home health, or healthcare billing experience preferred.
Experience working with electronic medical records and billing systems preferred.
Strong proficiency in Microsoft Office applications, including Microsoft Excel.
Ability to move up to 25 pounds with or without reasonable accommodation
Ability to alternate between sitting, standing, and moving throughout the workday
Must be able to travel to Cedar Vally Hospice locations as needed.
Pre-employment/post-offer physical, TB, and drug screen required

Nice To Haves

Bachelor’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or related field preferred

Responsibilities

Coordinates and manages revenue cycle functions to ensure timely, accurate billing & optimal reimbursement.
Prepares, submits, and monitors hospice claims to Medicare, Medicaid, managed care organizations, commercial insurance plans, and other third-party payers, in accordance with payer requirements and guidelines.
Completes monthly billing processes in accordance with payor requirements and organizational timelines.
Reviews electronic remittances, payer remittances, electronic funds transfers, and explanations of benefits for payment accuracy.
Reviews monthly accounts receivable billing audits conducted by the EMR and follows up for discrepancies such as levels of care, certifications of terminal illness, scheduled services, physician visits, and other billing requirements.
Maintains current knowledge of Medicare hospice billing regulations, payer requirements, and reimbursement changes.
Ensures Medicare billing requirements, including Notices of Election (NOEs), Notices of Termination/Revocation (NOTRs), payer attestations, and other required submissions.
Monitors patients with third-party payors for insurance prior authorizations requests.
Provides billing-related EMR support and assists staff with troubleshooting.
Prepares month-end accounts receivable journal entries, reconciliations, accruals, and related revenue cycle activities.
Prepares accounts receivable, reimbursement, and billing reports as requested.
Provides revenue cycle information to support budgeting and forecasting activities.
Collaborates with Admissions, Clinical Teams and Finance staff to ensure accurate billing and reimbursement.
Communicates with nursing facilities and external partners regarding billing questions, documentation needs, and reimbursement issues.
Provides support and education to staff regarding billing processes, payer requirements, and documentation expectations.