Job Description

Job Description

Job Description

Description:

MISSION, VISION, & VALUES

Our MISSION …to bring out the courage in others.

Our VISION …to be recognized as the market leader in operating provider-led, clinically-integrated networks of high quality, value-oriented services across the healthcare spectrum.

Our VALUES ...Trust, Integrity, Teaching, Collaboration, Transparency, Innovation, Discipline.

JOB SUMMARY

The Billing Representative is responsible for overseeing all revenue activities, including the coordination of claim submissions and the reimbursement process, ensuring compliance with all state and federal regulations. This role requires close collaboration with patients, staff, and insurance providers to address inquiries and resolve escalated issues promptly. The Billing Representative reports directly to the Reimbursement Manager and contributes accurate accounts receivable (AR) reporting and cash flow updates.

RESPONSIBILITIES

• Verify the preparation and timely submission of all claims to ensure prompt payment and contractual compliance.
• Mentor and coach new Billing Representatives, staying current on all Medicaid and Medicare laws and regulations relevant to the program.
• Address escalations and questions from patients, staff, and insurance companies regarding billing matters.
• Certify that all pre-bill audits are completed to ensure compliance with state and federal guidelines.
• Monitor the processing of payments from insurance companies and patients, following up on any invoices unpaid within 60 days of submission.
• Coordinate AR reporting and provide cash flow updates to the Reimbursement Manager.
• Participate in educational activities and attend weekly and monthly staff meetings.
• Conduct all activities in accordance with the employee manual, maintaining confidentiality and adhering to HIPAA guidelines and regulations.

QUALIFICATIONS

• Experience in hospice and/or home health billing required.
• 2+ years of applicable healthcare reimbursement experience is preferred.
• Knowledge of medical billing and collection practices, as well as basic medical coding and third-party payer processes.
• Proficiency in computer programs and familiarity with business office procedures, including basic accounting concepts.
• Strong organizational skills and attention to detail.
• Ability to operate basic office equipment and respond to telephone inquiries in a courteous and helpful manner.
• Skill in reading, understanding, and following written and verbal instructions.
• Ability to establish and maintain effective relationships with patients, employees, and the public.

WORKING ENVIRONMENT

This position operates in a typical office environment, requiring frequent sitting and occasional standing, with manual dexterity needed for using a calculator and computer keyboard.

JOB RELATIONSHIPS

Supervised by: Reimbursement Manager

RISK EXPOSURE

Minimal risk, primarily involving adherence to HIPAA guidelines and data confidentiality.

LIFTING REQUIREMENTS

This role primarily involves tasks associated with a standard office environment, requiring minimal physical lifting.

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