The Elizabeth Hospice is San Diego's oldest non-profit hospice of 40 years. We are growing and looking for talented individuals to join our high performing team and support our mission. We serve all of San Diego county and south Riverside county with multiple hospice office locations.
Our Mission: To enhance the quality of life for those nearing the end of life's journey and for those who grieve.
We place a high importance on our employees and reward staff in several ways such as:
Competitive hospice industry compensation
Benefits package with multiple plan offerings and generous employer contribution
401(k) Retirement plan with employer match
Supportive work culture which encourages work life balance
Substantial Paid Time Off, paid holidays & birthday benefit
Employee development program managed by in-house education department to support individualized orientation and professional growth needs.
Tuition Reimbursement program
Monthly mileage reimbursement
Employee Referral Program
Business casual attire for office staff
Responsibilities
The Billing Specialist is responsible for timely submission of claims to insurance companies from a wide variety of medical providers and facilities, as well as monitoring and ensuring payments for medical services are received in a timely manner. Medical biller/collector may also function as an intermediary between healthcare providers, clients, patients and health insurance companies. Collection Teams are organized by payer in most cases, however, biller/collectors should be familiar with Medicare, Medi-Cal, commercial, and work compensation payers.
Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
Verifies payer information and bill accuracy prior to processing.
Timely follow-up on processed claims that have not paid within 45-day period.
Retrieve claims status reports in E'solutions and payer portals to determine claims ready for processing and RTP (return to provider) claims that need correction.
Check eligibility and benefit verification.
Obtains authorization for services. Also obtains follow up authorizations as required by specific insurance companies.
Call all insurance contacts and use of insurance portals to gather additional information for claim payment.
Cash payment posting via EDI and paper checks.
Review cash batches for completeness and closure.
Organize workload to effectively manage billed AR aging and timely filing requirements.
Update payer information in Netsmart as needed.
Ensure that eligibility and benefit information is documented for all patient accounts.
Requires professional communication with insurance companies, facility registration personnel, physicians' offices and patients.
Accurately interpret managed care contracts.
Responsible to ensure that secondary claims are sent and paid.
Analysis of insurance plans to ensure accurate insurance plan selection and correct data entry is essential.
Bill and/or rebill claims.
Analyze claims and denials by running reports and contacting insurance carriers for claim resolution.
Generate appeals and grievance letters for denial reconsideration.
Follow-up with insurance carriers via phone and web portals.
Willingness to cross train.
Give timely response to patient account questions and concerns.
Assists in maintaining patient information and data in accordance with HIPAA regulations.
Work with A/P to ensure SNF invoices are paid timely.
Communicate with facilities on any room and board issues.
Submit NOE's and NOTR's as required by Medicare.
Mail DHCS Letter of notification of Medi-Cal /Medi-Cal HMO patient's to notify of patient's admission/ discharge/revocation/ transfer, including those who are Medi-Medi at a SNF with corresponding documents via mail.
Other Duties as assigned.
Qualifications
Qualifications:
High School diploma or equivalent.
Experience in a medical office environment required and Hospice experience preferred.
3 years Medical billing experience.
ICD-10 experience preferred.
Strong skills in Microsoft Excel, Word and Outlook. Allscripts and E'Solutions experience preferred.
"The Elizabeth Hospice is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law."
