Biller Department - Home Care
Full time; Benefitted
Monday-Friday --- 8:00am-4:30pm
Why UnityPoint Health?
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This position provides comprehensive management of billing process/client accounts for services rendered.
Processes Medicare/Medicaid Notice of Election (NOE, physician certification, and discharge forms per CMS regulations.
Receives patient/legal representative sign Medicare/Medicaid Notice of Election (NOE) from staff performing initial assessment and enters into Ability Ease system within 3 working days of admission.
Follows up on any NOEs not received timely.
Follows up on NOEs not accepted by Medicare, fixes errors, and resubmits.
Submits NOE information to Illinois Department of Public Aid via forms/on-line as required.
Determines which payment period the patient is in and notifies Hospice Leadership and Medical Director.
Tracks attending physician and Medical Director certifications to ensure both are received timely so billing process can begin.
Receives patient discharge information and processes notification to CMS that patient has been discharged within 1 day of discharge.
Generates charges for services in the hospice billing software on a timely basis.score: N/A
Generates recurring charges for Medicare patients monthly.
Generates recurring charges for insurance patients monthly.
Generates room and board charges for IDPH patients in skilled nursing facilities as bills from those facilities are received.
Generates accurate, clean claims in a timely manner.score: N/A
Generates electronic claims to Medicare every 15 days.
Ensures Medicare bills are filed in sequential order as required by Medicare – ensuring efficient billing cycle.
Generates paper claims for Illinois Department of Public Aide and private insurance companies every 15 days.
Posts payments and completes follow-up on unpaid or over-paid claims.score: N/A
Ensures cash posting occurs at time of receipt. For each posting, cash received is reconciled to payment posting report generated by the billing software.
Ensures cash received is reconciled monthly with Finance Department
Identifies why claims may be rejected, resolving and correcting the claim for resubmission.
Investigates open accounts to define steps for payment/close.
Documents and performs necessary adjustment billings.
Completes monthly review of individual accounts outstanding beyond target is completed with manager.
Ensures documentation of account follow-up is retrievable.
Ensures quarterly overpayment reports are completed and filed promptly with CMS and Illinois Department of Public Aid.
Promptly and courteously assists patients/families with billing questions.
Basic UPH Performance Criteria
Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.
Demonstrates ability to meet business needs of department with regular, reliable attendance.
Employee maintains current licenses and/or certifications required for the position.
Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.
Completes all annual education and competency requirements within the calendar year.
Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff. Takes appropriate action on concerns reported by department staff related to compliance.
High School graduate or GED equivalent preferred.
Associates Degree in Business preferred.
Previous clerical experience required.
1-3 years of experience in/with managing healthcare accounts and/or working with Medicare, Medicaid and commercial insurance is preferred.
General knowledge of accounting is preferred.
Previous office, home health, or hospice background is preferred.