| Location | Port Orange, Florida |
Medicare Billing Specialist - Hospice
mmary
Performs financial services for Hospice specific Medicare billing. Includes verification of patient Medicare eligibility, processing the Medicare Notice of Election (NOE), Notice of Election Termination/Revocation (NOTR) submission and hospice to hospice transfers. Submits the various claim types electronically to Medicare and tracks progress of claims. Post the electronic and manual remittance advices and processes them with appropriate sequestration adjustments. Responsible for Medicare accounts receivable outcomes; prepares monthly AR status of all Medicare accounts; Maintains current knowledge of Medicare Hospice Benefit/Regulations.
EDUCATION:
High school diploma or equivalent required.
EXPERIENCE:
More than 2 years of experience in the Medicare billing field or work-related knowledge. Sufficient experience to develop the knowledge and skills necessary to perform the position responsibilities. Experience with Microsoft Word and Excel and other software systems, preferably Medicare web-based programs.
JOB QUALIFICATIONS
SKILLS AND EXPERIENCE:
CERTIFICATIONS:
DUTIES AND RESPONSIBILTIES:
Access Medicare sites to determine hospice eligibility and benefit periods and enter in Netsmart.
Enters the Medicare NOE within 5 days of hospice admission. Also responsible for entering hospice transfers, discharges, or revocations into the Medicare access website. (81a, 81b, 81c, and 81d).
Performs Medicare claim processing for electronic and manual claims, including tracking and corrections. This includes all claim types such (811, 812, 813, 814, 817).
Checks and sends out claims from late EMC file daily.
Processes hospice re-admissions to make sure 81a and 81b are processed timely along with sending claims for final claims for first admission.
Responsible for Medicare accounts receivable outcomes. Statuses and tracks monthly AR and sends out report for Finance manager.
Coordinates with other hospices regarding mutual patients that we are having billing issues with.
Processes electronic and manual remittance advices with appropriate adjustments.
Prepares data for the quarterly Medicare Credit Balance Report and provides to managers for review, signature and submission.
Prepares Medicare accounts for month end closing to ensure Enclara RX prints on claims.
Maintains current knowledge of Medicare Hospice Benefit and Billing using CMS and Palmetto GBA websites.
Other duties as assigned.