Billing and Collections Specialist

Location:Full-time/Part Time/Flex FTE (hours/week) | Shift | Monday-Friday | HoursMake a lasting impact with AgraceJoin Agrace, a nationally recognized nonprofit leader in hospice and palliative care. If you are looking for a role that helps support meaningful, patient-centered care, this is your opportunity to make a difference!How You’ll Make a Difference (Essential Functions)The Billing and Collection Specialist is responsible for accurate and timely billing and collection of patient accounts and for collaborating with members of the finance department as well as other departments within Agrace to assure the accuracy and efficiency of the billing system for our palliative care program. The B & C Specialist will also be responsible for the billing, collections and reconciliation of Room & Board for patients residing in Nursing Homes.Key ResponsibilitiesPatient Billing:Verification of all required documentation and insurance coverage that supports billing is on file.Generate accurate and timely claims to meet filing requirements for all pay sources and secondary payors.Accounts Receivable and Collections:Review, analyze, monitor, and collect accounts receivable balances to ensure it is accurate and timely.Follow up on aging claims to resolve issues to collect outstanding balances, and file appeals as needed.Document all collection efforts and recommend write-offs when accounts become uncollectable. Obtain required approvals for these adjustments.Collect on patient self-pay balances based on statements sent out.Track progress and payments on the AR spreadsheet, with notes in Epic on each accountNursing Home Room and Board:Billing MA for nursing home, creating accounts for each patient (most done monthly)Sending invoices and reimbursements to Nursing HomesFollowing up on non-payment from Medicaid for room & boardCreating Retro File for Medicaid patientsReconciling that all billing for Nursing Homes has been sent to Medicaid (using work Q and Forward Health) including rates calculationsPaybacks to NH for the 5% for MCOsCheck WQ’s for follow up on Medicaid claims focusing on Room and Board Medicaid, Room and Board not Medicaid, Stop Bill ErrorsTrack progress and payments on the AR spreadsheet, with notes in Epic on each accountOther Duties:Participate in internal work groups, meetings, and committees relative to position responsibilities.Stay current with billing regulatory changes and contribute to system and process improvement.The above are not to be construed as exclusive or all-inclusive. Other duties may be required and assigned.You Bring (Qualifications)High school diploma or GED or equivalent combination of education and work experience3 – 5 years’ customer service in a healthcare setting with prior insurance experienceAbility to maintain professional boundaries with patients, families, and co-workersAbility to work effectively and cooperatively with othersAbility to lead conversations and resolve conflictsCompetence in culture/ethnicity, gender, race, age, and educational background diversityAbility to communicate effectively verbally and in writingExperience with electronic health records (EHR); Epic preferredBenefits:Competitive pay with free parkingHealth, dental, and vision insurance for employees who are hired for 28+ hours per week (.7 FTE +)Retirement plans with employer matchingGenerous Paid Time Off (PTO) and holiday paid time offComprehensive onboarding, mentorship, and career developmentAbout AgraceFor more than 45 years, Agrace has been an innovator and leader in both caring for patients and their families, and in educating others about death, dying and grief. We are the largest hospice provider in Wisconsin. Well known for end-of-life care, Agrace also serves people across southern Wisconsin who are aging, seriously ill or grieving.At Agrace we are strengthened by the unique experiences, cultures and traditions of our staff, patients and clients.Together, we pursue a vision in which every Agrace staff member is treated fairly, and every patient and client experiences the respectful, individualized care they need and deserve.We foster a culture of belonging that celebrates people’s uniqueness and leads to meaningful, empathetic connections.Agrace Health Inc is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #J-18808-Ljbffr Agrace