Billing and Outside Claims Specialist

Job DescriptionJob Description Our Accolades.Four Seasons is proud to have been named one of Modern Healthcare’s Best Places to Work, and to have been Living Wage Certified in Western North Carolina. Our approach to providing not only excellent care to our patients and families, but also providing the same heartfelt care and commitment to our employees, leads us to be recognized as not only a leader in hospice and palliative care, but also a beacon of excellence as an employer in Western North Carolina. Our Benefits.Four Seasons offers an excellent benefits package for both full time and part time eligible employees, which may include:Competitive Salaries, Reviewed AnnuallyAnnual Operational Performance Bonus Opportunities$0 Employee Premiums on Medical InsuranceAnnual $600 Well-Care Benefit Towards Self-Care, Childcare, Pet Care, or Elder CareMedical & Dental Insurance Benefits First of the Month after Hire403B Retirement Plan with Employer MatchGenerous Paid Time Off Package: 20+ Days of PTO Per YearUp to 6 Paid HolidaysEmployer Paid STD, LTD, & Life InsuranceEmployer Paid Teletherapy & Telemedicine CoverageHealth & Dependent Care Flexible Spending AccountsA Robust Employee Wellness ProgramUp to $3k in Tuition Reimbursement Each Year Billing and Outside Claims SpecialistReports ToDirector of Billing StatusFull time, Hourly (Non-exempt) ShiftMonday-Friday, 8:00am - 4:30pm LocationFlat Rock, NC Position Summary:This position is responsible for the accurate, timely and effective collection of all hospice and palliative patient accounts. Duties will also include data entry needs of the Billing Department while demonstrating excellent customer service with both internal and external customers. The Specialist must exhibit the technical competency, work ethic, attitude, discipline and communications skills required by Four Seasons to attain specified monthly, quarterly and fiscal year goals, and to work as part of a cohesive Billing Team. Essential Duties & Responsibilities:Process Palliative Care patient statementsPerform Palliative Care cash postingAssist Billing Team with tasks/responsibilities during times of high volume and cover areas needed while others are on PTOCommunicate effectively with Billing Team members and other department staff members related to billing needsServe as a resource and respond to patient accounting and billing questions from patients, responsible parties, staff, and all reimbursement sourcesAssist with Tracker AuditingMaintain adequate documentation related to patient account dataVerify benefits and completes patient eligibility, as neededBilling of all claims for hospice and palliative care services to Medicare, Medicaid, Private Insurance and Private Pay using practice management system and other billing software tools as neededPost payments and adjustments into patient accounts software as neededDemonstrate excellent communications and customer service skills with patients, families, staff & vendorsAdhere to confidentiality regarding patients, families, staff and the organizationOther duties as assignedKnowledge, Skills & Abilities:Knowledge of HIPAA privacy policiesExcellent organization skillsExcellent written, oral, and collaborative communication skillsExcellent interpersonal skillsExcellent attention to detail and accuracyProficient in MS Office: Outlook, Word, Excel, etc.Ability to work independently with minimum supervisionAbility to work under pressure to meet deadlinesAbility to take initiative and utilize innovative techniquesAbility to interact with various departments throughout the organizationAbility to participate as a team playerAbility to plan, prioritize and coordinate daily tasksHonor, exhibit and respect the organizational values of: Compassion, Balance, Respect, Integrity, Teamwork, and ExcellencePerform other duties as requested by Billing ManagerMinimum Qualifications:Education: Associate’s degree in Healthcare, Business, or equivalent experience in a related fieldContinuing education or professional development related to healthcare billing and administration, preferredExperience:Experience with Medicare Part A & B billing, Private Insurance, Private Pay preferredExperience with computerized medical billing systems; Suncoast and/or Carecloud experience preferredLicensures & Certifications: (if applicable)Certified Professional Coder, preferredSummary of Physical Requirements: Ability to sit for prolonged periods of time; in excess of four hours per dayConstant use of hands to finger, handling, or feeling; reach with hands and arms; and talk; or hearAbility to occasionally lift and/or move up to 10 poundsSpecific vision abilities required are close vision and distance vision with the ability to adjust focus, as neededIntent & Function:All descriptions have been reviewed to ensure that only essential functions and basic duties have been included. Peripheral tasks, only incidentally related to each position, have been excluded. Requirements, skills, and abilities included have been determined to be the minimal standards required to successfully perform the duties of the position. In no instance, however, should the duties, responsibilities, and requirements delineated be interpreted as all-inclusive. Additional functions and requirements may be assigned as deemed appropriate. In accordance with the Americans with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals. JOB DESCRIPTIONS ARE NOT INTENDED AS AND DO NOT CREATE EMPLOYMENT CONTRACTS. THE ORGANIZATION MAINTAINS ITS STATUS AS AN AT-WILL EMPLOYER.