Reimbursement Specialist II

BRISTOL HOSPICE LLC • Salt Lake City, UT

13d • $24 - $27 • Onsite

About The Position

As a Reimbursement Specialist II, you will be responsible for the accurate and timely completion and submission of Medicare, Medicaid, private payer and patient billing, and accounts receivable tracking and follow-up. Bristol Hospice is a nationwide industry leader committed to providing a family-centered approach in the delivery of hospice services throughout our communities. We are dedicated to our mission that all patients and families entrusted to our care will be treated with the highest level of compassion, respect, and dignity. For more information about Bristol Hospice, visit bristolhospice.com or follow us on LinkedIn. Our Culture Our culture is cultivated using the following values: Integrity: We are honest and professional. Trust: We count on each other. Excellence: We strive to always do our best and look for ways to improve and excel. Accountability: We accept responsibility for our actions, attitudes, and mistakes. Mutual Respect: We treat others the way we want to be treated.

Requirements

• Must have three (3) years of experience in health care billing/training, preferably in a hospice care system
• Must have one (1) year of previous hospice care related billing experience
• Knowledge of insurance reimbursement and authorization process preferred
• HealthWyse and/or HealthCare System knowledge is preferred
• Must be able to work under tight deadlines and under sometimes stressful situations
• Must be skilled in the use of computers and the Microsoft Office applications
• Medical Billing Certificate preferred

Responsibilities

• Perform daily audit of admission, discharge and other source documentation to ensure revenue is recognized appropriately and all conditions of payment are met
• Verify patient eligibility and payor coverage guidelines to ensure that all necessary information is secured for timely, accurate revenue recognition
• Generate weekly list of all Medicare/Medicaid, Private Insurance and Self Pay revenue and resolution of batch errors and bill holds as appropriate
• Provide weekly communication with site leadership detailing outstanding documentation or other issues resulting in a potential loss of revenue for assigned sites and all payer team members as needed
• Prepare and submit invoices to accounts payable for reimbursement and perform follow-up to ensure accurate, timely payments are made to our facility partners when applicable
• Prepare, submit and follow up on authorization and re-authorization requests according to applicable state and commercial payor guidelines
• Coordinate, review, and analyze documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing
• Ensure all internal controls and related policies/procedures are implemented and followed in accordance to accounts receivable requirements
• Ensure all payer requirements are met accordingly, including pre-cert requirements, Medicare notification requirements, and level of care change required documents
• Audit for compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures
• Assist with training of newly hired associates, as well as re-education of revenue teams as necessary
• Serve as the information resource for any hard revenue generation issues or system issues
• Maintain Medicare A & B logs and follow up on denials, non-payments, etc. with the Director of Reimbursement on progress of claims and follow up status
• Submit Quarterly Medicare Credit Balance Report
• Prepare/review and submit appeal information as needed to payor sources
• Assist other billers with Medicare/Medicaid, other payors and DDE issues, as needed
• Assist in the preparation of monthly billing and accounts receivable reports
• Accurately enter patient billing data, pharmacy and supply charges, into the practice management system
• Follow up on claims with the payer sources to ensure payment
• Validate patient responsibility and eligibility on State and Managed Care plans
• Maintain database Rates and Fee schedules
• Assist with the collection of receivables by monitoring accounts receivables, resubmitting bills to overdue accounts, and alerting the billing director of seriously overdue accounts
• Maintain admission and readmission deadlines to meet sequential billing deadlines
• Submit/oversee submission of Medicare Notice of Elections Intermediary submission timelines
• Establish and maintain positive working relationship with patients, payors, and other internal and external customers
• Always maintain the confidentiality of patient and organization information
• Other duties as assigned

Benefits

• Tuition Reimbursement
• PTO and Paid Holidays
• Medical, Dental, Vision, Life Insurance, and more
• HSA & 401(k) available
• Mileage Reimbursement for applicable positions
• Advanced training programs
• Passionate company culture committed to the highest standard of care in the hospice industry
• Join a Team that embraces the reverence of life!

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed