Division: Home Office
Encompass Health’s home health & hospice services are now Enhabit Home Health & Hospice. We remain committed to delivering a better way to care for our patients and their loved ones, helping them achieve their specific care goals in the comfort and safety of their own homes. As one of the largest Medicare-certified home health and hospice providers in the nation, we continue to set the industry standard for superior home-based care.
Location of job: 2400 John Hawkins Parkway, Birmingham, AL 35244
Hours: Monday - Friday, 8am-5pm or 9am - 6pm
The hospice billing coordinator is responsible for assigned patients from the point of referral through eligibility, verification and election of benefits (EOB) workflow, to zero balance in accounts receivable. This position is responsible for ensuring that the payor is set up accurately; verified coverage, benefits, election number is accurate in Homecare Homebase (HCHB).
The hospice billing coordinator owns their assigned payors, states and patients; this includes one hundred percent compliant billing, review of payment/EOB, processing of any required funds, and coordinating any required adjustments.
- Monitor HCHB for eligibility, verification, validation and authorization of the payor source entered upon referral, and ensure accurate and compliant payor set-up.
- Validate and document contracted status with branch office during eligibility/workflow stage in HCHB; enter billing coordination note in HCHB accordingly.
- Validate plan requirements for precert-authorization-lock in, and according to payor source guidelines, validate hospice benefit number, lock in with other agency, primary versus secondary payors, deductible, copay, coinsurance, covered versus non-covered, service limits, lifetime benefit limit, and level of care guidelines for routine, general inpatient, respite and continuous care; enter billing coordination note(s) in HCHB accordingly.
- Verify and document any special circumstances or handling that will be required to bill and obtain accurate payment; enter billing coordination note in HCHB if applicable.
- Document room and board eligibility with effective dates and out of pocket amounts in a HCHB billing coordination note for all assigned room and board eligibility workflow.
- Transmit UB/CMS 1500 claim forms to payor source according to team guidelines, and document successful receipt of each in the AR section of HCHB for non-Medicare, and on monthly spreadsheet for Medicare. Report any unsuccessful transmissions to manager immediately.
- Monitor for unbilled claims and communicate details to the branch; coordinate solutions.
- Communicate with payor for change in level of care, live discharge, or death as required for assigned payor requirements.
- Research all unpaid claims timely, once every 30 days at minimum. Correct unpaid claims if applicable, resubmit if possible, and prepare and submit appeal if appeal rights are available. Complete follow up and collection calls.
- Research and resolve every credit balance in AR within 30 days of the credit appearing; follow department guidelines.
- Research and resolve every under and over payment, and document findings in AR notes; follow department step-by-step processes for resolution.
- Answer central phone line a minimum of twice daily, addressing questions from branch office staff, patients, caregivers and payors.
- Must have a high school diploma or equivalent.
- An associate degree in accounting, business, or related field is desired.
- Two years of experience in Medicare or other insurance billing, coding, and/or related billing tasks is preferred.
- A certification in billing or medical terminology is preferred.
- Must have demonstrated use of a 10-key and be able to type 45 words per minute.
- Must have demonstrated experience with medical terminology and data entry.
- Must be adept at communicating with a broad range of individuals to foster mutual respect.
- Must possess excellent customer service skills.
- Must have strong attention to detail.
- Must be well organized and able to manage multiple projects simultaneously in a high volume environment, prioritize tasks appropriately, and finish work within deadlines.
- Must have good problem-solving skills and the ability to analyze information to determine proper compliance.