Hospital Billing Specialist

THE CONNECTICUT HOSPICE INC•Branford, CT

1d•$28 - $30•Onsite

About The Position

The Connecticut Hospice Hospital is seeking an experienced, detail-oriented Medicare billing and claims submission specialist to support its healthcare revenue cycle operations in Branford, Connecticut. The role requires knowledge of Medicare billing guidelines, claims processing, hospice and healthcare reimbursement methodologies, commercial payer requirements, and payment posting. The specialist ensures accurate and timely claim submission and reimbursement while maintaining compliance with applicable regulations and payer requirements. The position prepares and submits claims, manages corrections, resubmissions, appeals, payment posting, and accounts receivable follow-up, and works with payers, providers, patients, and internal teams to resolve billing issues. The position is full-time and based at the organization's headquarters in Branford, Connecticut. Compensation is listed as $28.00–$30.00 per hour.

Requirements

Minimum 2–3 years of medical billing and claims processing experience.
Strong working knowledge of Medicare billing regulations and CMS guidelines.
Experience with Medicare/Medicaid and commercial insurance carriers and payer-specific billing requirements.
Proficiency in charge entry, payment posting, and accounts receivable follow-up.
Experience resolving claim denials and managing appeals.
Strong knowledge of ICD-10, CPT, and HCPCS coding principles.
Familiarity with electronic medical records (EMR) and billing software systems.
Excellent data entry accuracy and attention to detail.
Strong organizational, communication, and problem-solving skills.
Ability to sit at a desk and work at a computer for extended periods.
Ability to use the telephone frequently.

Nice To Haves

Experience in hospice, home health, skilled nursing facilities, respite, palliative care, or healthcare revenue cycle management.
Preferred coding credentials include Certified Inpatient Coder (CIC), CCS, CPC through AAPC, inpatient-focused AHIMA credentials, or Home Care Coding Specialist–Hospice (HCS-H) through AHCC.
Preferred billing credentials include Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or a similar certification.
Knowledge of assigning ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes, and managing MS-DRG reimbursement rules.
Knowledge of Medicare Advantage and managed care plans.
Experience with inpatient and home health hospice claims processing and reimbursement requirements.

Responsibilities

Prepare, review, and submit Medicare, Medicaid, and commercial insurance claims accurately and on time.
Ensure compliance with CMS regulations, Medicare Claims Processing Manual guidelines, and payer-specific billing requirements.
Manage claim submissions, corrections, resubmissions, and appeals for denied or rejected claims.
Verify patient insurance eligibility and benefits.
Process Notices of Election (NOE), Notices of Termination/Revocation (NOTR), and other applicable Medicare-related transactions.
Monitor and resolve billing issues, claim edits, and reimbursement discrepancies.
Post insurance payments, patient payments, adjustments, and contractual allowances accurately.
Reconcile accounts receivable balances and follow up on unpaid claims.
Research and resolve claim denials by communicating with payers, providers, and patients.
Maintain accurate billing, payment, and patient account records.
Stay current on Medicare regulations, reimbursement methodologies, and commercial payer policy updates.
Collaborate with clinical, administrative, and finance teams to support revenue cycle operations.
Generate billing and accounts receivable reports as needed.