- SERVICE THE POSITION IS FOR: Hospice of Holland
- POSITION REPORTS TO: Director of Finance
- DEPARTMENT: 08 – Finance
- FLSA CATEGORY: Non-Exempt
- WORKERS COMP CLASS: Clerical
- EEO CATEGORY: Administrative Support Workers
Job Description Summary
The role of the Billing Administrator is to ensure that Hospice of Holland is paid for medical services rendered. Responsible for all aspects of accurate patient accounts receivable including, but not limited to, insurance verification, billing, claims follow-up, and posting of payments. Negotiation with commercial insurers may be required.
Essential Job Functions
- 1. Maintain comprehensive working knowledge of government billing regulations including Medicare and Medicaid as they relate to both Physicians (Part B) and Hospice (Part A). Must have similar working knowledge for commercial carriers. Serves as a resource for clinical staff.
- 2.Verify patient insurance coverage.
- 3.Submit accurate claims to insurers and statements to patients.
- 4.Ensure that claims are correctly paid and process payments.
- 5.Monitor unpaid claims and maintain updated status, call for collection purposes.
- 6.Enter patient services into the EMR or other records as required.
- 7. Sort and file paperwork.
- 8.Maintain accurate data base files for the billing department, accounts receivable modules, and electronic billing system.
- 9.Specific assignments may include credentialing the company and providers with third party payers.
- 10.Specific assignments may include medical coding including handling information about patient treatment and diagnosis to ensure proper coding.
- 11.Specific assignments may include processing Accounts Payable invoices, checks for accuracy, authorization, and completeness of supporting documentation; cuts and distributes checks.
- 12.Specific assignments may include processing Payroll.
The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.
All employees are required to comply with the policies and procedures of Hospice of Holland, Inc. and with all state, federal, and other regulatory requirements. They will also comply with confidentiality laws as described in the Notice of Privacy Practices as well as accepted professional standards and practice.
Education and Experience
- 1.Education: Associates Degree in Accounting/Business Administration or equivalent work- related experience preferred.
- 2.Experience: At least three years of healthcare related billing and collections experience preferably for a hospice, hospital, nursing home, or physician practice.
- 3.Other: ICD-10/HCPCS/CPT coding education and/or experience preferred.
Skills and Knowledge:
- 1.Ability to focus attention to detail and accuracy.
- 2.Ability to read, analyze, interpret, and implement changes to technical procedures and governmental regulations.
- 3.Excellent communication and organizational skills.
- 4.Ability to identify problems and solve them using research, common sense, and numeric reasoning.
- 5.EMR and medical billing software skills required as well as a working knowledge of Office 10.
Quality Orientation – Accomplishing tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
Technical/Professional Knowledge and Skills – Having achieved a satisfactory level of technical and professional skill or knowledge in position related areas; keeping up with current developments and trends in areas of expertise.
Managing Work – Effectively managing one’s time and resources to ensure that work is completed efficiently.
Adaptability – Maintaining effectiveness when experiencing major changes in work tasks or the work environment; adjusting effectively to work within new work structures, processes, requirement, or cultures.
Performs a variety of routine work within established policies and procedures that allow for some discretion as to how and when the work is to be performed. Use of training and knowledge to problem-solve, make decisions, and determine the best course of action from within a framework of established options. Seeks advice and further direction when situations are out of the ordinary and/or do not fall within existing instructions. Priorities and outcomes are determined by the supervisor, or some external reference. Work is checked periodically to ensure compliance with procedures and policies.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities.
While performing the duties of this job, the employee is regularly required to sit. The employee will also be required to repeat the same hand, arm or finger motion many times. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust and focus. The employee must occasionally communicate through speech. The employee must occasionally lift and/or move up to 50 pounds.
The working conditions described here are representative of those encountered in the job. Specific conditions may be different than those described. Reasonable accommodations may be made to enable individuals with disabilities.
- 1.Will work inside.
- 2.Will have close and prolonged exposure to computer screens.
- 3.Will be required to meet deadlines, occasionally with severe time constraints.
Continuing Education Requirements:
Hospice personnel are expected to participate in appropriate continuing education as may be requested and/or required by their immediate supervisor. In addition, Hospice personnel are expected to accept personal responsibility for other educational activities to enhance job-related skills and abilities.