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Medicare Billing Specialist

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Date: Oct 3, 2018

Location: Richardson, TX, US, 75081

Company: Envision

Billing Specialist - Medicare

Ascension at Home is growing and looking for Medicare Billing Specialists to join our team.

We’re seeking candidates with:

  • Minimum 5 years of Medicare and DDE experience required
  • Home Health/Hospice experience preferred, not required

Job Summary:

Medicare Billing Team Member is responsible for ensuring the preparation and submission of clean claims daily for all assigned hospitals in an electronic or paper format.

Essential Duties and Responsibilities:

  • Review charges, patient information, and insurance information prior to billing to minimize underpayment, denials and re-bill attempts.
  • Verifies successful import of claims from host system daily. Reconciling both number of claim count as well as dollars of daily import.
  • Working knowledge of CMS guidelines to include Medicare the DDE and FSS systems.
  • Works additional daily reports (72 hr report, prior day rejection report, etc) to ensure these claims are added timely to the daily transmission.
  • Timely submission of clean, accurate claims of all hospitals assigned either electronic or paper according to payer/hospital requirements and following specific state and federal guidelines per established procedures. To include primary, secondary, and tertiary insurance companies with the appropriate explanation of benefits (EOB) attached, if applicable.
  • Works errors and halted claims daily. Ensures additional transmission of the corrected claims are completed by end of day or designated time depending on facility, system and or clearinghouse.
  • Selects and prints any claims designated as paper (once errors have been corrected).
  • Mails paper claims daily attaching any additional pertinent documentation necessary to ensure prompt adjudication and payment of the claim.
  • Ensures proper account documentation which is clear, concise and includes all pertinent information.
  • Add claims needing additional information from facility (i.e., medical records, authorization numbers etc) is added to appropriate request log to ensure timely completion of claim transmission.
  • Consistently follows established processes and procedures for all assigned accounts and projects to ensure prompt payments and account resolutions.
  • Makes appropriate and necessary corrections to patient account information after verification from the facility as needed to ensure timely correction and submission of claim.
  • Immediate and appropriate escalation of payor trends and issues to management which impact cash, aging and processes.
  • Maintains or exceeds 95% of established productivity goals and quality standards.
  • Utilizes electronic software in all daily activities, documenting account daily following established procedures.
  • Promotes working toward paperless environment by identifying potential new electronic payors
  • Ensures professional verbal and written communication with facilities, clients and co-workers following established guidelines. Obtains management approval when necessary to communicate with external clients about internal processes and procedures.
  • Follows and maintains patient, account and client confidentiality at all times. Adheres to HIPAA and Compliance Policy Guidelines.
  • Follows time-keeping and attendance policy daily.

Educational and Experience Requirements:

  • High school diploma or GED required.
  • Required 5 years of hospital medical billing experience.
  • Specific knowledge of Medicare, Commercial, Third Party Insurance Accounts. Rules and Guidelines governing billing activities.
  • Specific working knowledge of electronic claims editing software (SSI, ePremis, DSG, CPSI and Emdeon preferred). CPT4 codes, ICD10 codes, UB04, HCFA, Medical Terminology as well as rules and guidelines (State, Federal) governing claim processing.
  • Appropriate use of Modifiers including NCCI edits, LCDs and NCDs as applicable for specific facility/payor assigned.

Certificates, Licenses and Registrations:

Medical Billing and Coding Certificate a plus, not required.

Mathematical Skills Required:

  • Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages.
  • Proficiency in the use of a 10-key.

Computer Operations:

  • Previous experience should include basic computer knowledge.
  • Knowledge of Microsoft Word and Excel required.
  • Working accounts in a computerized automated environment.
  • Knowledge of billing software ie. SSI, ePremis, Emdeon etc.

Company Overview

Ascension at Home is a leading provider in the delivery of compassionate patient-centered healthcare services including home health, infusion therapy and hospice.

Formed in 2014, Ascension at Home is a national partnership between Ascension Health and Evolution Health. The partnership includes all Ascension-affiliated home health, hospice, home infusion therapy and private duty/supportive care services. Visit us at to learn more about our organization and view all career opportunities.

Nearest Major Market: Dallas
Nearest Secondary Market: Fort Worth

Job Segment: Medical, Medicare, Clinic, Palliative, Hospice, Healthcare

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