Enrollment & Billing Representative jobs in Cedar Falls, IA

The Hospice Billing Specialist plays a vital role in ensuring the financial health of our hospice facility. Responsible for accurately billing Medicare, Medicaid, private pay, and other insurance for hospice services provided to patients, as well as managing room and board billing for patients receiving inpatient and facility care. Attention to detail, understanding of Medicare and Medicaid regulations, and ability to navigate complex billing systems will be critical in this role.

Qualifications:

• High School diploma or equivalent required; associate or bachelor’s degree in healthcare administration, finance, or related field preferred.
• Previous experience in healthcare billing, with specific experience in Medicare billing preferred.
• Proficiency with billing software and electronic medical record (EMR) systems.
• Strong understanding of Medicare regulations and guidelines related to hospice billing.
• Excellent attention to detail and accuracy in data entry and recordkeeping.
• Effective communication skills, both written and verbal.
• Ability to work independently and collaboratively in a fast-changing environment.
• Strong organization and time management skills.
• Familiarity with HIPAA regulations and patient privacy requirements.

Medicare/Medicaid and Insurance Billing:

• Prepare and submit claims for hospice services provided to patients in accordance with Medicare and Medicaid regulations and guidelines.
• Accurately processes and bills Medicare, Medicaid, private payer, other insurance providers and patient claims in accordance with payer requirement and organization policy.
• Review patient records to ensure accurate coding and documentation supporting billed services.
• Monitor claims for accuracy and completeness, addressing any discrepancies or issues promptly.
• Follow up on unpaid or denied claims, resubmitting claims as necessary and appealing denied claims when appropriate.
• Stay current on changes to Medicare, Medicaid and other insurance billing regulations and requirements.

Room and Board Billing:

• Manage room and board billing for patients receiving inpatient care at the hospice home or other inpatient facilities.
• Ensure accurate and timely invoicing of room and board charges to patients or their responsible parties.
• Work closely with the intake or admissions team to verify patient information and ensure billing accuracy.
• Address patient inquiries related to room and board charges, providing clarification and assistance as needed.
• Collaborate with insurance companies and other third-party payers to facilitate payment for room and board services.

Documentation and Recordkeeping:

• Maintain detailed records of all billing activities, including claims submitted, payments received, and outstanding balances.
• Document any communications or interactions related to billing inquiries or disputes.
• Ensure compliance with HIPAA regulations and maintain the confidentiality of patient information.

Collaboration and Communication:

• Collaborate with the interdisciplinary hospice team, including nurses, physicians, social workers, and administrators, to ensure accurate billing and documentation of services.
• Communicate effectively with internal stakeholders and external parties, including patients, families, insurance companies, and government agencies.
• Continuous Improvement:
• Identify opportunities for process improvement and efficiency in billing operations.
• Participate in training programs and continuing education to stay current on industry best practices and regulatory changes.

Other duties as assigned by Executive Director or designee.

Job Type: Part-time

Pay: $19.70 - $23.73 per hour

Expected hours: 24 – 32 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Office

Ability to Relocate:

• Marshalltown, IA 50158: Relocate before starting work (Required)

Work Location: In person