Hospital Billing Specialist

Hospital Billing SpecialistThe Connecticut Hospice Hospital is seeking an experienced and detail-oriented Medicare Billing & Claims Submission Specialist to join our healthcare team in Branford, Connecticut. The ideal candidate will have extensive knowledge of Medicare billing guidelines, claims processing, hospice and healthcare reimbursement methodologies, commercial insurance payer requirements, and payment posting procedures. This position requires strong analytical skills, accuracy, and the ability to ensure timely claim submission and reimbursement.Guiding PrinciplesWe provide quality, compassionate, and competent care. We support families with their decision-making. We support families with participation in caring for their loved ones. We aid in enhancing the quality of life for all our patients, for as long as their life lasts.Essential Duties and ResponsibilitiesPrepare, review, and submit Medicare, Medicaid, and commercial insurance claims accurately and timely.Ensure compliance with CMS regulations, Medicare Claims Processing Manual guidelines, and payer-specific billing requirements.Manage claim submissions, corrections, resubmissions, and appeals for denied or rejected claims.Verify patient insurance eligibility and benefits.Process Notices of Election (NOE), Notices of Termination/Revocation (NOTR), and other Medicare-related transactions as applicable.Monitor and resolve billing issues, claim edits, and reimbursement discrepancies.Post insurance payments, patient payments, adjustments, and contractual allowances accurately.Reconcile accounts receivable balances and follow up on unpaid claims.Research and resolve claim denials by communicating with payers, providers, and patients.Maintain accurate billing, payment, and patient account records.Stay current on Medicare regulations, reimbursement methodologies, and commercial payer policy updates.Collaborate with clinical, administrative, and finance teams to support revenue cycle operations.Generate billing and accounts receivable reports as needed.This document does not create an employment contract, implied or otherwise, other than an "at will" relationship. The above noted job description is not intended to describe, in detail, the variety of tasks that may be assigned but rather to give the incumbent a general sense of the responsibilities and expectations of his/her position. As the nature of business demands change, so, too, may the essential functions of this position.QualificationsEducational Requirements, Qualifications, & TrainingsMinimum 2-3 years of medical billing and claims processing experience. Strong working knowledge of Medicare billing regulations and CMS guidelines. Experience with Medicare/Medicaid and commercial insurance carriers and payer-specific billing requirements. Proficiency in charge entry, payment posting, and accounts receivable follow-up. Experience resolving claim denials and managing appeals. Strong knowledge of ICD-10, CPT, and HCPCS coding principles. Familiarity with electronic medical records (EMR) and billing software systems. Excellent data entry accuracy and attention to detail. Strong organizational, communication, and problem-solving skills.Physical Requirements & Work EnvironmentMust be able to sit at a desk and work at a computer for extended periods of time. Requires frequent telephone use. The qualifications, physical demands, and work environment described herein are representative of those an employee will encounter and must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities.