Billing / Records Specialist
CorsoCare Hospice, Milford, MI
- Full Time, Hybrid
- Competitive wages
- Comprehensive benefits
- Generous PTO/Holiday (23 days first year)
- Tuition reimbursement
- Opportunities to grown with us!!
Position Summary:
The Billing and Records Specialist under the direction of the Administrator, is a high-level clerical position. This position requires the ability to understand CMS rules related to the hospice program as it relates to tracking multiple identifiers. This position may be requested to coordinate activities between agency clinical managers, intake coordinator, office manager, scheduling, QA, and inside/outside resources. Supervises and serves as a reference to Scheduling, Medical Records, and Office Personnel Coordinator. This is an exempt position.
This position will ensure our organizational quality goals are met, and the Agency remains compliant with all relative regulations, policies, and procedures.
Required Experience:
- High school graduate or GED; Some post-secondary coursework strongly preferred.
- Minimum of two (2) years of experience in a healthcare or hospice setting.
- Knowledge of Medicare, Medicaid, and third-party reimbursement requirements.
- Information system knowledge in the areas of electronic data entry and report generation.
- Knowledge of Microsoft Outlook 365, Microsoft Teams, Microsoft Work/Excel, faxing, scanning, professional phone etiquette, and uploading documentation into EMR system.
- Demonstrates organizational skills, detail orientation, flexibility, and ability to work with minimal supervision.
- Demonstrates excellent verbal and written communication skills.
- Ability to maintain attention and accuracy while attending to multiple tasks simultaneously.
- Ability to read and interpret documents, such as policy and procedures manuals, clinical documentation, and physician orders.
- Ability to speak effectively before groups of customers or employees of the organization.
- Compliant with accepted professional standards and practices.
- Consistently maintains a positive attitude which promotes team and optimal performance.
Responsibility for Hospice Billing / Records Specialist:
- Leads and serves as a reference to Scheduling, Medical Records, and Office Personnel Coordinator
- Verifies that all required patient information is present prior to preparing claims.
- Submits NOE (Notice of Election) and timely billing of all patient accounts including Medicare, Medicaid, third party payors. Achieve maximum reimbursement for services provided.
- Serves as a resource person to all Hospice employees.
- Knowledgeable of intermediary billing policies and requirements.
- Promptly follows up with each denial claim. Submits required documentation for each denied claim within established time frame.
- Assists Administrator with investigation of received invoices for timely payments and ensures submission of invoice to Account Payables.
- Performs Admission and Discharge HIS (Hospice Item Set) submissions.
- Supervise, maintain, and report on scheduling, medical records, site level payroll, and personal files. Conducts appropriate audits.
- Attend all appropriate meetings to provide reports and information requested regarding billing, scheduling, and medical records.
- Maintains confidential patient communications and records in accordance with privacy and security standards of the Health Insurance Portability and Accountability Act (HIPAA). Adheres to agency standards, policies, procedures, and applicable federal and state laws.
- Report cases of possible abuse, neglect, fraud, noncompliance, and exploitation to the Compliance Officer, Administrator or Designee immediately.
- Participate in the Agency’s Emergency Preparedness and Emergency Preparedness Communications plans and helps coordinate Clinician communication when the Plan is activated.
- Perform administrative staff duties such as answer phones, emails, faxing/scanning, and customer communications.
- Must be available to routinely work staggered shifts with the possibility of some evening, early morning, weekend, or holiday coverage if needed.
- Compliant with all applicable laws, regulatory requirements, standards of practice, CHAP accreditation standards, and policies and procedures.
- Runs reports and provides information to clinical managers about issues regarding their patients.
- Work toward continual improvement of the overall Agency.
- Maintains OSHA and Infection control per policy.
- Performs assigned administrative services.
Skills for Success:
- Building strong relationships, 1440 Care Standards.
- Making good and timely decisions.
- Taking on new challenges with a sense of urgency.
- Working efficiently and effectively and continuously improves.
- Working well with others to meet shared goals.
- Communicating clearly and frequently.
- Relating openly and honestly with diverse group of people.
- Rebounding quickly from setbacks.
- Stepping up to address difficult issues, saying what needs to be said.
- Gaining the confidence and trust in others.
- Using feedback and personal reflection to gain personal insight into strengths and weaknesses.
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