Hospice Billing Specialist

Role Overview

• Implements and adheres to VitalCaring’s established Hospice billing Standard Operating Procedures, ensuring compliance with Medicare Hospice Conditions of Participation and regulatory guidelines.
• Prepares, reviews, and submits hospice claims accurately and timely, including Medicare, Medicaid, Managed Care, and other third-party payors.
• Ensures proper billing of hospice levels of care, including Routine Home Care (RHC), Continuous Home Care (CHC), General Inpatient Care (GIP), and Inpatient Respite Care (IRC).
• Verifies timely Notice of Election (NOE) submission and ensures hospice election statements, physician certifications, and recertifications are complete and compliant prior to billing.
• Reviews documentation to confirm appropriate revenue codes, occurrence codes, discharge status codes, and length of stay compliance.
• Identifies, investigates, and resolves billing edits, claim rejections, denials, and payment discrepancies, including coordination of benefit (COB) scenarios.
• Collaborates with Branch Directors, Clinical Managers, and Admissions teams to obtain missing documentation and resolve discrepancies impacting reimbursement.
• Accurately documents billing coordination notes in the EMR to ensure effective communication between branch and revenue cycle teams.
• Uploads remittance advices, payor correspondence, and supporting documentation into the EMR according to company guidelines.
• Monitors and reconciles payments, ensuring accurate posting and identification of underpayments or overpayments.
• Meets or exceeds established productivity and quality benchmarks while maintaining accuracy and compliance.
• Maintains strict confidentiality of all patient and financial data in accordance with HIPAA and company policies.
• Supports audit preparedness, including ADRs, TPE reviews, and other Medicare or third-party payor audits.
• Participates in ongoing education regarding hospice reimbursement updates, regulatory changes, and industry best practices.
• Performs other duties as assigned to support operational and revenue cycle excellence.

Requirements

• Minimum of one (1) year of healthcare billing experience, with hospice billing strongly preferred.
• Working knowledge of Medicare Hospice reimbursement regulations.
• Notice of Election (NOE) requirements.
• Levels of care billing (RHC, CHC, GIP, IRC).
• Denial management and appeals processes.
• Electronic Medical Records (EMR) systems.
• High school diploma or equivalent required; Associate’s degree in Healthcare Administration, Business, or related field preferred.
• Strong analytical skills and attention to detail with the ability to manage multiple billing cycles simultaneously.
• Proficiency in Microsoft Office and billing software systems.
• Reliable transportation (if position requires branch presence).

Benefits

• Medical, Dental & Vision
• Pharmacy Benefits
• Virtual & Mental Health Support
• Flexible Spending Accounts (FSAs) & Health Savings Account (HSA)
• Supplemental Health & Life Insurance
• 401(k) with Company Match
• Employee Referral Program
• Prepaid Legal Plans
• Identity Theft Protection
• Paid Time Off
• Pet Insurance
• Tuition & Continuing Education Reimbursement