Medical Biller

St Maries•Southfield, MI

2d•$45,000

About The Position

St. Marie's Hospice is seeking a experienced medical biller for its tea. The Medical Biller is responsible for the accurate and timely submission of hospice claims in compliance with Medicare, Medicaid, and other payer regulations. This position plays a critical role in maintaining cash flow, regulatory compliance, and financial integrity for the organization. The Medical Biller will manage all aspects of the billing cycle, including Notice of Election (NOE) filings, claims submission (UB-04), payment posting, denial management, accounts receivable follow-up, and hospice cap tracking. The ideal candidate has direct experience with Medicare hospice billing requirements and understands the regulatory framework governing hospice reimbursement. This role requires strong attention to detail, knowledge of CMS Hospice Conditions of Participation, and the ability to work collaboratively with clinical and administrative staff to ensure documentation supports clean claim submission.

Requirements

Strong customer service skills
3 years medical billing required / hospice billing preferred
Strong organization skills
Excellent attention to detail

Responsibilities

Medicare & Payer Billing Prepare and submit accurate hospice claims (UB-04) to Medicare, Medicaid, and commercial payers.
Ensure timely filing of Notices of Election (NOE) and Notices of Termination/Revocation (NOTR/NOR) in accordance with CMS regulations.
Verify eligibility and benefits prior to billing.
Review clinical documentation to ensure compliance with billing requirements.
Monitor and reconcile daily census to ensure accurate billing cycles.
Revenue Cycle Management Track and manage Accounts Receivable (A/R).
Follow up on unpaid, denied, or rejected claims in a timely manner.
Investigate and resolve billing discrepancies and payer rejections.
Post payments and adjustments accurately.
Monitor timely filing limits to prevent lost revenue.
Hospice Compliance & Cap Monitoring Monitor hospice aggregate cap and inpatient cap reporting.
Track benefit periods and certification timelines to prevent billing errors.
Ensure documentation supports level-of-care billing (Routine Home Care, Continuous Care, General Inpatient, Respite).
Maintain compliance with CMS Hospice Conditions of Participation.
Reporting & Financial Oversight Generate weekly and monthly billing and A/R reports.
Track clean claim rate and identify trends in denials.
Assist leadership in forecasting revenue.
Support audit preparation and respond to Additional Documentation Requests (ADRs).
Collaboration & Communication Work closely with clinical staff to ensure documentation supports claims.
Communicate with families regarding billing inquiries when appropriate.
Coordinate with intake and admissions staff to confirm payer authorization.
Report potential compliance risks to leadership promptly.
Administrative Duties Maintain organized billing records and electronic documentation.
Stay current on Medicare and Medicaid billing updates and regulatory changes.
Participate in compliance training and internal audits.