Reimbursement Specialist II

Job DetailsJob Location: Bristol Hospice - Salt Lake, UT - SALT LAKE CITY, UT 84116Position Type: FT HourlySalary Range: $23.00 - $27.00 HourlyJob Shift: DayAs a Reimbursement Specialist II, you will be responsible for the accurate and timely completion and submission of Medicare, Medicaid, private payer and patient billing, and accounts receivable tracking and follow-up.

Bristol Hospice is a nationwide industry leader committed to providing a family-centered approach in the delivery of hospice services throughout our communities. We are dedicated to our mission that all patients and families entrusted to our care will be treated with the highest level of compassion, respect, and dignity. For more information about Bristol Hospice, visit bristolhospice.com or follow us on LinkedIn.

Our Culture

Our culture is cultivated using the following values:

Integrity: We are honest and professional.

Trust: We count on each other.

Excellence: We strive to always do our best and look for ways to improve and excel.

Accountability: We accept responsibility for our actions, attitudes, and mistakes.

Mutual Respect: We treat others the way we want to be treated.

Qualifications, Duties, PerksAn Average Day:

(Includes, but not limited to)

Perform daily audit of admission, discharge and other source documentation to ensure revenue is recognized appropriately and all conditions of payment are met

Verify patient eligibility and payor coverage guidelines to ensure that all necessary information is secured for timely, accurate revenue recognition

Generate weekly list of all Medicare/Medicaid, Private Insurance and Self Pay revenue and resolution of batch errors and bill holds as appropriate

Provide weekly communication with site leadership detailing outstanding documentation or other issues resulting in a potential loss of revenue for assigned sites and all payer team members as needed

Prepare and submit invoices to accounts payable for reimbursement and perform follow-up to ensure accurate, timely payments are made to our facility partners when applicable

Prepare, submit and follow up on authorization and re-authorization requests according to applicable state and commercial payor guidelines

Coordinate, review, and analyze documentation and data entry supporting Medicare,

Medicaid, and commercial payer requirements to ensure accurate and timely billing

Ensure all internal controls and related policies/procedures are implemented and followed in accordance to accounts receivable requirements

Ensure all payer requirements are met accordingly, including pre-cert requirements, Medicare notification requirements, and level of care change required documents

Audit for compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures

Assist with training of newly hired associates, as well as re-education of revenue teams as necessary

Serve as the information resource for any hard revenue generation issues or system issues

Maintain Medicare A & B logs and follow up on denials, non-payments, etc. with the Director of Reimbursement on progress of claims and follow up status

Submit Quarterly Medicare Credit Balance Report

Prepare/review and submit appeal information as needed to payor sources

Assist other billers with Medicare/Medicaid, other payors and DDE issues, as needed

Assist in the preparation of monthly billing and accounts receivable reports

Accurately enter patient billing data, pharmacy and supply charges, into the practice management system

Follow up on claims with the payer sources to ensure payment

Validate patient responsibility and eligibility on State and Managed Care plans

Maintain database Rates and Fee schedules

Assist with the collection of receivables by monitoring accounts receivables, resubmitting bills to overdue accounts, and alerting the billing director of seriously overdue accounts

Maintain admission and readmission deadlines to meet sequential billing deadlines

Submit/oversee submission of Medicare Notice of Elections Intermediary submission timelines

Establish and maintain positive working relationship with patients, payors, and other internal and external customers

Always maintain the confidentiality of patient and organization information

Other duties as assigned

Requirements:

Must have three (3) years of experience in health care billing/training, preferably in a

hospice care system

Must have one (1) year of previous hospice care related billing experience

Knowledge of insurance reimbursement and authorization process preferred

HealthWyse and/or HealthCare System knowledge is preferred

Must be able to work under tight deadlines and under sometimes stressful situations

Must be skilled in the use of computers and the Microsoft Office applications

Medical Billing Certificate preferred

We Got the Perks: (full-time benefits)

Tuition Reimbursement

PTO and Paid Holidays

Medical, Dental, Vision, Life Insurance, and more

HSA & 401(k) available

Mileage Reimbursement for applicable positions

Advanced training programs

Passionate company culture committed to the highest standard of care in the hospice industry

Join a Team that embraces the reverence of life!

EEOC Statement

Bristol Hospice is an equal-opportunity employer. Our success depends upon our ability to create and maintain a diverse and supportive work environment where individuality is promoted. Bristol puts high priority on the worth of every person. We do not base our hiring decisions on race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.