Hospice Medicare Billing and Collections Representative

Role:
The Medicare Billing and Collection Representative is responsible for processing and submission of third party claims, denial management, and account resolution.

Qualifications: • High School Diploma or GED • Minimum of one (1) year of medical billing and collection experience • Knowledge of third party billing and state and federal collection regulations preferred • Ability to prioritize and multi-task independently with little supervision • Must be self-motivated and service oriented • Excellent written and verbal communication skills • Accurate typing and data entry skills Competencies: • Satisfactorily complete competency requirements for this position. Responsibilities of all employees: • Represent the Company professionally at all times through care delivered and/or services provided to all clients. • Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse. • Comply with Company policies, procedures and standard practices. • Observe the Company's health, safety and security practices. • Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company. • Use resources in a fiscally responsible manner. • Promote the Company through participation in community and professional organizations. • Participate proactively in improving performance at the organizational, departmental and individual levels. • Improve own professional knowledge and skill level. • Advance electronic media skills. • Support Company research and educational activities. • Share expertise with co-workers both formally and informally. • Participate in Quality Assessment and Performance Improvement activities as appropriate for the position. Job Responsibilities: • Prepares and submits accurate billing to third party payor’s and self-pay invoices. • Identifies and resolves billing clearinghouse rejections. • Conducts root cause analysis on unpaid accounts receivable (AR) and resolves with third party payor’s. • Analyzes and resolves credit balances. • Handles incoming and outgoing customer service calls to third party payor’s, outside providers and patients/guarantors to resolve and achieve account resolution. • Processes correspondence. • Initiates and resolves technical denial appeals. • Identifies payor denial and cash fluctuation trends and escalates as appropriate. • Performs other duties as assigned.