BILLING SPECIALIST II

Job Summary:
Under the direction of the Director of Revenue Cycle, responsible for all aspect of billing and collections for all pay sources, following all compliance and regulatory requirements. Completes all billing workflow in an efficient and timely manner.

Job Duties:
• Keep in compliance of regulatory compliance requirements related to billing.
• Completes workflow in the EHR system for verification, eligibility and authorizations
• Reviews and processes the coordination workflow and completes action items
• Performs all billing functions, daily, weekly and monthly. (Medicare, Medicaid, third party, self-pay, Hospice
• Verifies all Medicaid patients' eligibility on the first of each month.
• Initiates Travel Patient Agreements and Authorization for Services that are identified in the workflow
• Initiates Authorization for Services that are identified in the workflow
• Reviews patient account balances for credits and process refunds if appropriate
• Participates in monthly aging meeting with CFO and Director of Revenue Cycle
• Participates in weekly team meeting
• Participates in weekly 1:1 meetings
• Compose and mail out benefit summary letters (Commercial Insurance, Medicaid, and SelfPay)
• Send notifications of hospice admission and/or deaths to DCF
• Process Medicaid applications and follow up on additional information requests from DCF to process the application
• Check status regularly of Medicaid applications in process and inform patient's Social Worker of status including any new information required
• Notifies contracted hospitals when a patient chooses Hospice while in their hospital
• Notifies contracted Nursing Facility when a resident at their location as chosen admission to Hospice Care and when patient is discharged from Avow.
• Participates in monthly aging meeting with CFO and Director of Patient Accounts
• Field phone calls from outside vendors, patients/families, etc. and assist with billing concerns
• Maintains and reviews, as necessary, the billing system for Hospice, including patient's accounts payable and receivable.
• Bills related software, such as Medicaid Portal for Medicaid and on-line services available for Medicare.
• Manages and coordinates billing and collection functions for programs as assigned
• Collections follow up per procedure.
• Maintains current information on Medicare and Medicaid and prepare required reports.
• Works together with team and other organizational departments to ensure that the needs of patients are being met in relation to billing and authorizations.
• Other duties as assigned by the Director or CFO.

Core Values:
Innovation:
We embrace change and are always looking at creative ways to solve problems and serve new populations.

Integrity:
We are honest, hardworking, fiscally responsible professionals driven solely by the well-being of our patients, their loved ones, and the communities we serve.

Collaboration:
We know we cannot achieve everything we want without working hand-in-hand with each other, with our healthcare partners, and with the community.

Celebration: We believe in the importance of celebrating life and relationships.

Education:
We believe it is important not only to serve the community but to educate community members about our services and the role we can play at the end of life.

Education and / or Experience:
Bachelor's Degree (B.A.) or equivalent from four-year college or technical school; or two to five years of related experience and/or training; or equivalent combination of education and experience.

Certificates, Licenses, Registrations:
Current Driver's License.

Computer Skills: Experienced in hospice and/or healthcare billing software; word processing software; spreadsheets and general computer usage.

Mathematical Skills: Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

Language Skills: Ability to read, analyze, and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports, business correspondence. Ability to effectively present information and respond to questions from groups of customers, clients, or employees of organization.

Reasoning Ability: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in standardized situations.

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.) Must be able to stand, walk, stoop, kneel, crouch, or crawl up to 1/3 of work time; sit or use hand to finger, handle, feel, talk or hear over 2/30 of work time; reach with hands and arms 1/3 to 2/3 of work time. Must be able to lift up to 25 pounds. Special vision requirements; close vision (clear vision at 20 inches or less); distance vision (clear vision at 20 feet or more); color vision (ability to identify and distinguish colors); peripheral vision (ability to observe an area that can be seen up and down or to the left and right while eyes are fixed on a given point); depth perception (three-dimensional vision, ability to judge distances and spatial relationships); ability to adjust focus (ability to adjust the eye to bring an object into sharp focus).

Work Environment: (The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.) Some exposure of working near moving mechanical parts. Noise level is moderate (business office with computers and printers, light traffic).

Compensation and Benefits:
This is only a summary of our employee benefits; it is subject to change.

• Medical insurance (PPO) with prescription drug co-pay or HDHP w/HSA
• Supplemental Benefits (hospital confinement, accident and/or cancer)
• Dental insurance
• Vision Insurance
• Life and accidental death/dismemberment insurance (company paid)
• Long term care insurance (company paid)
• Retirement savings plan (TSA/403(b) matching program)
• Short and long term disability insurance (company paid)
• LegalShield (identity protection and more)
• Bereavement leave for family and pets
• Direct deposit
• Credit union availability
• Employee Assistance Program
• Paid time off
• Mileage reimbursement
• In-house continuing education opportunities
• Discounted membership at local area Fitness Center
• Tuition reimbursement
• Other employer-sponsored activities

Avow is a Tobacco Free Organization which includes but is not limited to cigarettes, electronic cigarettes, vaping, cigars, cigarillos, pipes, chewing tobacco, snuff, dip, and loose tobacco smoked via pipe or hookah. And due to the above, Avow will only hire Nicotine Free individuals.

All applicants offered a position are required to complete a screening through the Clearinghouse. For more information, click here