Hospice Medicaid Biller

Halifax Health•Port Orange, FL

About The Position

Hospice Medicaid Biller The Finance Clerk II performs Hospice patient-related Accounts Payable functions, coordinates work distribution and provides direction and education under the direction of the Financial Director. JOB SUMMARY: Responsible for daily electronic claims processing and tracking, electronic and manual remittance advice processing with appropriate adjustments. Responsible for accounts receivable outcomes. Maintains current knowledge of Hospice Benefit Regulations.

Requirements

High School diploma or GED equivalent required.
Associates Degree or sufficient on the job experience required.
Knowledge of medical office accounting systems required.
Proficient computer skills, with the ability to use Word and Excel required.
Knowledge of DDE, Medicaid Portal, Availity, EPIC, Optum/Inovalon clearing houses
Possess strong skills in Microsoft Excel and Word
Minimum of two years’ experience in healthcare billing and/or business office setting, preferably in Hospice
Must be able to work independently, able to finish tasks with minimal supervision

Nice To Haves

2-3 years Finance experience preferred.
Allscripts Homecare beneficial

Responsibilities

Prepare and process patient related accounts payables and maintain check registers.
Respond to vendor requests for information.
Maintain current vendor demographics in Allscripts, and forward changes to HH A/P.
Maintain files of approved/paid and denied invoices.
Prepare Journal Entries for HH-Finance on an as needed basis.
Process approved A/P Charity Requests and maintain permanent records.
Prepare spreadsheets and reports as needed.
Responsible for gathering patient information and completing Medicaid Applications, to include screening, document review, follow-up and submission
Processing electronic and manual remittance advices with appropriate adjustments.
Balance daily posting, A/R follow-up on a daily basis.
Assists with claim corrections of Medicare, Medicaid and Commercial payers. Timely and accurately.
Maintains current knowledge of Hospice Benefit regulations.
Maintains knowledge of department A/R policies and procedures.
Prepares weekly collections reports for review with the Supervisor.
Daily Medicaid Verifications and Admissions.
The job involves processing, monitoring, and collecting claims in accordance with payer requirements, verifying billing data accuracy, and importing/posting payments from all payer types.
Follows up on all denied, rejected and/or pending claims in a timely manner, utilizing all electronic means available.
Initiates timely appeals and reconsiderations with payers by telephone, letter, email or other electronic media or spreadsheets.
Evaluate and resolve accounts by utilizing resources including, but not limited to, bills, remittances, correspondence, worklists and insurance calls in accordance to payer specific guidelines in a timely manner.
Reconcile nursing home room & board patient responsibility against Medicaid payments.
Bi-Annually (January & July) research and system update of Room & Board Rate changes.
Prepare and submit AHCA Complaints on payer claim denials as needed.
Assist with Medicaid and Commercial Authorizations.
Ensure account information is current by entering notes, documentation and changes at time of occurrence.
Timely completion of Month End tasks.
Review Medicaid program code changes for patients on our services.
Serves as back-up for Medicare and Commercial Insurances.
Completes assignments as requested.
Other duties as assigned.