Billing and Insurance Specialist Job In Troy, Michigan
Lead Biller, Home Health & Hospice
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Lead Biller, Home Health & Hospice
U.S. Medical Management (USMM) is an affiliate of a leading Fortune 100 company. A national organization built on a continuum of care with premier healthcare providers, clinicians and patient focused individuals working together. Our Mission – “Through Compassionate Patient-Centered Care in the Home; We will Provide Exceptional Outcomes across our Continuum of Services” – Visiting Physicians Association, Pinnacle Senior Care, Grace Hospice, Comfort Hospice, Home DME & our In Home Health Assessments (IHA).
Our Values of Integrity, Respect, Teamwork & Excellence are leading us to a better tomorrow for patient care. Our Purposes Centered on “We are Unified in our Work through our Continuum of Services” “We can Find Comfort that We are Making a Difference for our Patients” & “We make a Broader Positive Impact on Society”, allows USMM to be poised for a phenomenal future.
We are seeking candidates who desire the experience of delivering quality & compassionate healthcare within proven care models with patients at the forefront of everything we do.
The Lead Biller, Home Health & Hospice is responsible for supporting the manager in the processes related to the timely submission of claims, ensuring timely payment collections, and monitoring of accounts receivable aging buckets. This position will support the home health/hospice service line as assigned.
Essential Duties and responsibilities
- Implements efficient billing and collections systems and accounts receivable
- Ensures that client accounts are maintained according to accepted accounting principles and in accordance with all state, federal and payor standards
- Demonstrates knowledge of all payer contracts and follows specific requirements of the account when submitting claims
- Provides the team with payer updates as applicable
- Leads the team in effective Accounts Receivable management and follow-up of all outstanding accounts
- Assists with answering team questions and helping team members to think critically about billing and denials
- Oversee daily claim batch submissions for the team and help to resolve issues
- Recommends improvement to streamline billing and collections
- Reconciles Medicare reimbursement reports from the intermediary with the internal billing information systems to maintain accurate accounts receivable balances
- Collaborate with home health and hospice branch partners on Accounts Receivable issues and further education on policies and procedures
- Supports the billing manager in day to day operations, such as department metrics and productivity
- Assist manager in optimizing use of systems, such as e-Solution and Waystar enrollment and issue resolution
- Assist Billing Manager with Month End Close and bank sheets
- Assists with drafting departmental SOPs
- Leads team huddles in manager’s absence
- Assist the manager in training new hires and on-going team education
- Supports the cash posting process as a backup
- Maintain strict confidentiality of provider, company and patient information
REQUIRED Knowledge, Skills and Experience
- High School diploma required; additional education desirable
- Five years of previous experience in home health and/or hospice billing and collections
- Demonstrates knowledge of billing regulations for Medicare, Medicaid, and other insurance processing, billing terminology and coding
- Knowledgeable of regulatory standards for home care and hospice specific to the reimbursement area
- Information system knowledge in the areas of electronic claim submission and data entry/report generation
- Demonstrated organizational skills, detail orientation, flexibility, and ability to work with minimal supervision
- Strong Analytic and problem solving skills, organizational and interpersonal skills
- Ability to multi-task and work independently
- Excellent communication and organizational skills, verbal and written (end user support documentation, policies and procedures, etc.)
- Proficiency with Microsoft Word and Excel
- Experience with Home Care Home Base (HCHB,) DDE, Waystar
With more than 2000 employees across the country, USMM promotes an environment that is rooted in supporting the home-based, patient centered care that our family of companies provides.