Senior Billing Specialist

Dover Health is a part of The Dover Companies, a vertically integrated healthcare organization established in 2007, focused on providing comprehensive healthcare services to seniors through home health, hospice care, private duty services, and primary care. Dover Health aims to enable patients to remain in their homes with dignity and comfort. Position Summary: The Senior Billing Specialist reports directly to the Revenue Cycle Manager and is responsible for end-to-end hospice billing and revenue cycle functions, ensuring Medicare compliance, claim accuracy, and timely cash collections. Essential Duties Prepare, review, and submit hospice claims (Medicare, Medicare Advantage, Medicaid, and commercial) with high accuracy and timeliness. Ensure all claims meet hospice billing requirements (NOE, NOTR, rev codes, levels of care, sequencing). Monitor claim status and aggressively follow up on unpaid or denied claims, especially 60 and 90 days. Maintain in-depth knowledge of Medicare hospice billing rules, including election statements, benefit periods, caps, levels of care (Routine, GIP, Respite, Continuous Care), face‑to‑face requirements and physician certifications. Ensure compliance with all CMS billing regulations and documentation standards. Investigate, resolve, and appeal denied or underpaid claims; identify root causes of denials and implement corrective actions. Maintain accountability for AR aging and drive reduction in outstanding balances. Post all cash receipts, adjustments and contractual allowances accurately and timely. Reconcile payments to billed amounts and investigate discrepancies. Support month‑end close processes, including charge entry and reconciliation. Verify insurance coverage and patient responsibility prior to billing. Obtain and track authorizations where required. Conduct routine billing audits to ensure accuracy and regulatory compliance. Identify risk areas that could lead to denials, recoupments, or audit exposure. Maintain strict adherence to HIPAA and patient confidentiality standards. Monitor key billing KPIs (clean claim rate, denial rate, AR aging, days to bill, cash collections). Recommend and implement process improvements to increase efficiency and cash flow. Collaborate with clinical, intake, and leadership teams to resolve documentation or workflow issues impacting billing. Qualifications Associate’s or Bachelor’s degree in Healthcare Administration, Accounting, or related field is preferred. 3–5+ years of healthcare billing experience, with direct hospice billing experience required. Strong knowledge of Medicare hospice billing rules and regulations required. Experience with EMR/RCM systems and electronic claims submission required. Proven experience managing AR, denials, and collections required. Experience in both hospice and home health billing is preferred. Familiarity with Medicare Administrative Contractors (MACs) and payer portals preferred. Dover Health is an equal opportunity employer. In compliance with the Americans with Disabilities Act, we will provide reasonable accommodations to qualified individuals with disabilities and encourage prospective employees and incumbents to discuss potential accommodations with the employer. All offers of employment are contingent upon successful completion of a background check, drug screening, and required health assessments. #J-18808-Ljbffr