Job Description
Job Description Medical Billing Specialist is responsible for the complete and accurate billing and collections of all hospice claims submitted for payment to third-party payers, including, but not limited to, Medicare, Medicaid, Managed Care, commercial carriers, and any other state and federal health care programs. Performs all follow-up duties associated with rebilling, adjustments, corrected claim submissions, and collections of all overdue accounts/claims in accordance with best business practices. Must be able to work on-site at our Corporate Miramar, Florida office, Monday through Friday, 8am- 5pm work schedule.
- Meets established daily productivity standards.
- Schedule and download the daily bill job files and processes for transmittal.
- Research, correct, and re-submit rejected and denied claims.
- Responsible for timely billing whether by paper or electronic claim in the appropriate claim format.
- Monitor insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner- knowledge of questions to ask for proper processing.
- Responsible for identifying problems and solutions or enhancements to resolve billing issues including, but not limited to, billing frequency, required forms, and general billing requirements.
- Identify problem accounts and escalate as appropriate.
- Update the patient account record to identify actions taken on the account.
- Manages clearinghouse and payor accept/reject reports timely while ensuring all claim rejections are resolved within 72 hours of rejection occurrence.
- Logs repetitive errors or exceptions and reports them to management to ensure the admission record and related systems are properly updated and corrected.
- Coordinates with collectors and management to become familiar with the changing demands and requirements of payers in each state.
- Interacts with other areas and departments to troubleshoot and resolve issues that may not have standard documented solutions.
- Provide support to the Collectors by producing timely, accurate and complete billing documents.
- Stays abreast of changes in all editing processes as may be required.
- Acts as a resource for billing information and assists collectors and other staff members in producing any special documentation which may be required.
- Identify coding or billing problems from EOBs and work to correct the errors in a timely manner.
- Understands and serves and as subject-matter expert for billing specifications and requirements of assigned payers and states
- Understand Hospice Notice of Election (NOE) submission timing requirements and exceptions.
QUALIFICATIONS
- Three to four years prior experience in a general office environment (accounting or billing experience in a healthcare environment preferred)
- Knowledge of insurance billing guidelines including Medicare, Medicaid, and other third party payers.
- Possess a full understanding of the health care collections and reimbursement process, and an in depth knowledge of the insurance industry.
- Ability to work on various assignments simultaneously
- Strong interpersonal skills within all levels of the organization
- Ability to navigate within automated systems and proficiency in Outlook, Word and Excel
EDUCATION
- Completion of high school or basic education equivalency required.
SPECIAL INSTRUCTIONS TO CANDIDATES
About Us VITAS® Healthcare is the nation's leading provider of end-of-life care, and has the resources and expertise to support your personal and professional growth. As a member of the VITAS team, you'll find fulfillment working for a people-focused organization dedicated to making a difference in the lives of others. You will be more than just an employee: You will be counted on as an expert in your field, and as a valued team member whose efforts are respected and vital to our hospice mission.
All VITAS employees commit to fulfilling their duties and responsibilities with the highest regard for professionalism, collaboration and teamwork, and an eye focused constantly on growth and improvement. We serve with commitment and compassion, and position ourselves for the future by embracing, innovating, and leading change. If you are that person, make your voice heard-find your purpose at VITAS today.
Benefits Include:
- Competitive compensation
- Health, dental, vision, life and disability insurance
- Pre-tax healthcare and dependent care flexible spending accounts
- Life insurance
- 401(k) plan with numerous investment options and generous company match
- Cancer and/or critical illness benefit
- Tuition Reimbursement
- Paid Time Off
- Employee Assistance Program
- Legal Insurance
- Roadside Assistance
- Affinity Program
Many of our positions offer the opportunity to work day or night shifts, weekdays or weekends.
Choose a Career with VITAS
Job Tags
Work at office, Monday to Friday, Flexible hours, Night shift, Weekend work, Day shift, Weekday work