Hospice Billing Analyst I

SUMMARY

Support the Team Lead and Billing Supervisor to ensure timely and correct claims are filed with all respective payers and intermediaries for Hospice patients. Monitor claims for timely processing of payments and rejections and work on Accounts Receivable (A/R) weekly.

HOSPICE BILLING ANALYST ESSENTIAL DUTIES AND RESPONSIBILITIES

• Bill for Medicare/Medicaid/Blue Cross and other commercial payors under Hospice guidelines
• Complete/update room & board admissions/discharges in CHAMPS, Medi System
• Complete Illinois Medicaid & Managed Medicaid Enrollments/Discharges and submit to the State of Illinois
• Obtain Medicaid rate letters from facilities when rates are updated
• Update room and board rates in HCHB as required
• Process workflow in HCHB to set up room and board
• Develop and maintain relationships with skilled nursing facilities (SNF)
• Complete and submit HPF form to SNF within 24 hours of admission
• Manage monthly Medicaid billing for SNFs
• Communicate directly with Sales Team when SNF invoice payments are being held
• Monitor monthly Medicaid eligibility and maintain PPA updates
• Review unbilled reports for Medicaid and commercial room and board claims weekly
• Review Blue Cross 5th Level Claims in web-DENIS for payment dates
• Create and review room and board/respite invoices for accuracy
• Submit reviewed room and board/respite invoices to SNF for their review, obtain signatures, and correct any discrepancies
• Submit room and board invoices to AP, adhering to deadline date
• Review revenue and expenses related to room and board to ensure that payments sent to facilities tie to the payments received by the insurance carrier and the accounting system
• Update billing notes and follow up as required
• Review all payor remits filed in OneDrive by Accounts Payable
• Prepare and submit write-off/bad debt documentation to Hospice Billing Manager by monthly deadline for Revenue Cycle
• Work closely with AP department to resolve payment issue

• Perform claims adjustment/correction in CHAMPS, Medi, Waystar, web-DENSI, and commercial payor web portals

HOSPICE BILLING ANALYST QUALIFICATION REQUIREMENTS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• High School education or equivalent
• Minimum of one (1) year billing experience in the Hospice or Home Health industry
• Medicare FISS (Fiscal Intermediary Standard System)/DDE (Direct Data Entry) and CHAMPS experience preferred
• Experience using clinical billing software and electronic claims submission
• Knowledge of Hospice Medicare/Medicaid compliance
• Strong computer knowledge
• Experience navigating a computer network
• Proficient in Microsoft Office
• Experience using web-DENIS
• Experience using Commercial billing software/websites
• Demonstrate patience, flexibility, and cooperative attitude
• Conscientious with attention to detail
• Ability to multitask and work independently
• Excellent communication and organizational skills, verbal and written

CERTIFICATES, LICENSES, REGISTRATIONS

Must have and maintain in good standing professional license, certificate, or registration, as applicable.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.