Biller chez HOSPICE OF ACADIANA INC

Description

Reports To: Revenue Cycle Manager

JOB DESCRIPTION SUMMARY

The Biller manages all areas of the billing department. Oversees activities that contribute to the filing, billing, and payment of claims made with Medicare, Medicaid, and private insurance companies.

ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES

1. Ensures reimbursement through efficient billing and collections operations and effective accounts receivable management.
2. Ensures that billing and patient accounts record systems are maintained in accordance with GAAP and in compliance with state, federal, and Joint Commission regulations.
3. Maintains comprehensive working knowledge of payer contracts and ensures that payers are billed according to contract provisions.
4. Maintains comprehensive working knowledge of government billing regulations including Medicare and Medicaid regulations and serves as a resource for appropriate organization personnel.
5. Monitors aged accounts receivable and resubmits bills to overdue accounts and prepares bad debt reports for the Director of Finance.
6. Gathers, collates, and reports key billing information to the Director of Finance.
7. Works closely with Admit team under strict deadlines regarding processing of all admission information to prepare for appropriate Medicare and/or Insurance Elections and Auth. process.
8. Researches and combines information needed to create and process Medicare, Medicaid, and/or Insurance Claims in a timely manner according to Medicare guidelines.
9. Electronically imports Medicare and Insurance payments from all pay sources as they become available.
10. Reconciles payments and post them to Suncoast to prepare for monthly accounting closeout.
11. Troubleshoots issues with processing of payments, import of deposits, denial of payments, and any Suncoast processing errors.
12. Collaborates with other Hospice or facilities regarding billing patient transfers, admits, discharges, and certification periods.
13. Uses professional communication skills to speak with patients, families, and/or pay source representatives to handle any claim processing issues.
14. Updates billing rates with appropriate providers; also upload pharmacy into Suncoast daily.
15. Works with patient and/or family to assist with any documents they may need for cancer policies, etc.
16. Completes and submits Notice of Election.
17. Faxes prior authorizations as well as changes as requested for all Nursing Homes.

The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks or special projects, other than those stated in this description, by supervisors/Leadership Team. 

Qualifications

1. Education: High School Diploma or equivalent.
2. Experience: Minimum of three (3) years’ experience in Microsoft programs, Healthcare Billing, and/or Collections. Knowledge of Suncoast, Ability, and/or Waystar preferred.
3. Good time management and organizational skills.
4. Must be detail-oriented; able to prioritize and multitask.
5. Be familiar with medical terminology and insurance codes.
6. Knowledge of Medicare and Medicaid filing and billing requirements.