General Purpose:

Responsible for medical coding and medical billing for hospice patients. Ensures accurate and timely activities in all functions.

Essential Functions:

• Ensures reimbursement through efficient medical coding and medical billing. Must have already obtained certification in medical coding and medical billing.

• Ensures that billing and patient account records are maintained in compliance with state, and federal regulations.
• Maintains comprehensive working knowledge of payer contracts (private and public health care insurance) and ensures that payers are billed according to contract provisions.
• Maintains comprehensive working knowledge of government billing regulations including Medicare and Medi-Cal regulations and serves as a resource for appropriate organization personnel.
• Organizes, analyzes and reports key medical billing information to the Executive Director.
• Reconciles Medicare quarterly reports produced by the fiscal intermediary with the medical billing information system, and assists the Executive Director in the preparation of the annual Medicare cost report.
• Supervises the use of the billing information system and maintains a comprehensive working knowledge of the system including upgrades and enhancements.
• Establishes and maintains positive working relationships with patients, family members, payers and referral sources.
• Protects the confidentiality of patient and organization information through effective controls and direct supervision of medical billing operations.

• Willingness and commitment to participate in ongoing assignments that fall within other functional areas.
• May have access to personal health information (“PHI”) necessary to fulfill the above duties and responsibilities. Access to use and ability to disclose PHI is further defined by each organization/department.

Minimum Education & Experience Requirements:

• Must possess certification in medical coding and medical billing
• Preferred: Associate's degree.

• At least three (3) years experience in health care billing and coding preferably in hospice operations. Billing information systems knowledge required.

Knowledge, Skills & Abilities Required:

• Understands hospice philosophy.
• Demonstrated good communication, negotiation, and public relations skills.
• Demonstrated capability to accurately manage detailed information.
• Able to deal tactfully with patients, family members, referral sources and payers.
• Demonstrates autonomy, organization, assertiveness, flexibility and cooperation in performing job responsibilities.

Working Conditions & Physical Effort:

• Work is normally performed in a typical interior/office work environment.
• Physical activity is sedentary and may require occasional lifting or carrying up to 10 lbs.
• Ability to work flexible schedule and/or evening hours as needed.