POSITION SUMMARY

The Medical Billing Specialist is responsible for all payors (Medicare, Patient Pay, Medicare Secondary Payor, and Commercial Insurance) as assigned.  This position will be familiar with all of the provider numbers.

PRIMARY RESPONSIBILITIES 

1. Verify eligibility within a timely manner.
2. Submits NOE’s within the regulatory requirements for Medicare.
3. Submits claims, electronically (unless the insurance company only takes a paper claim) on a monthly basis to all payors as assigned   
4. Submit Medicare discharges within the regulatory guidelines or within two business days of discharge, whichever is shorter.
5. Submits Notices of Transfer (81C’s) within one week after the initial hospice has finished billing and also coordinates with the other hospice if claims are outstanding.
6. Generates and submits Medicare Secondary claims on a weekly basis.
7. Follows the process for patient pay. Which consists of contacting social workers to work with patient/families and processing the Financial Assistance Applications. Will process and send monthly statements, check to see if any patient pay accounts can be billed to probate, follow up on any outstanding patient pay accounts per Arkansas Hospice Policy.
8. Backs up the Medical Billing Specialist—NH.
9. Follows any changes to a patient’s account on a daily basis by reviewing and completing workflow in a timely manner.  Also, review Coordination Notes and complete Administrative Tasks in the Electronic Medical Record (EMR).
10. Follows up bi-weekly on all assigned patient accounts over 30 days old and will document in the EMR the information as to why the claims have not processed for payment.  Follow up on accounts in accordance with Finance Department guidelines.
11. Communicates with physicians’ offices, hospitals, insurance companies, and other providers to obtain required information on patient billing sources.
12. Takes call for the Finance Department on a rotating schedule to verify patient’s eligibility, Medicare benefit period, and notification of Face to Face visit if applicable, coordinate with the admission staff, and document in the EMR.
13. Verify physician visits with Health Information Management.
14. Assists the Finance Director and the Patient Accounts Manager as requested; assists with other office functions as required.
15. Handles confidential material with tact, diplomacy and discretion.
16. Maintains strict confidentiality at all times.
17. Utilizes and models excellent customer service skills at all times; seeks opportunities to assist patients, families and co-workers; demonstrates teamwork and cooperation.
18. Accepts direction and follows instructions from supervisor; seeks additional information as needed; works with minimal supervision.
19. Adheres to all organizational and departmental policies and procedures.
20. Continually meets organizational standards for attendance and punctuality; notifies supervisor in a timely manner when employee will be absent or late for work.
21. Attends all required meetings and inservices; seeks opportunities for additional professional development activities as appropriate.

COMPETENCIES, KNOWLEDGE, SKILLS, AND ABILITIES

THIS SECTION DESCRIBES WHAT KNOWLEDGE, SKILLS AND ABILITIES AN EMPLOYEE IN THIS POSITION SHOULD CURRENTLY POSSESS.  THIS LIST MAY NOT BE COMPLETE FOR ALL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED FOR THIS POSITION. 

1. Ability to communicate effectively both orally and in writing.
2. Ability to communicate effectively with co-workers and other customers.
3. Ability to follow basic safety policies and procedures.
4. Ability to use good judgment and to maintain confidentiality of information.
5. Ability to work as a team player.
6. Ability to demonstrate tact, resourcefulness, patience and dedication.
7. Ability to accept direction and adhere to policies and procedures.
8. Ability to work in a fast-paced environment.