Medicaid Billing Coordinator
Hospice of Michigan
Remote
medicaid
billing
coordinator
medicaid
insurance
hospice
billing
accounts
accounts receivable
community
champs
patients
assistance
December 5, 2022
Hospice of Michigan
Southfield, Michigan
FULL_TIME
- Job Summary:
Responsible for hospice billing and follow-up for Medicaid accounts receivable. Completes and submits the necessary claims and documentation to the MDHHS Community Health Automated Medicaid Processing System (CHAMPS) for payment processing and resolution. Also, maintains quality control of billing information in the electronic medical record.
- Essential Functions:
- Ensures all Medicaid hospice claims are billed timely and accurately.
- Works closely with the Nursing Home Billing Specialist to ensure that Medicaid room & board claims are billed properly.
- Maintains follow-up and claims tracking, resolving any denied or pended claims.
- Submits all hospice admission or discharge notices to Medicaid via CHAMPS on daily basis.
- Runs monthly Medicaid eligibility status for all Medicaid patients and updates EMR accordingly.
- Serves as Domain Administrator within CHAMPS for NorthStar Care Community (NSCC) entities and applicable providers.
- Performs revalidation of all applicable NSCC providers within CHAMPS.
- Responds to inquiries from patients, families, nursing homes and NorthStar staff regarding insurance coverage, dates of service, level of care, and changes in collection of Medicaid PPA.
- Maintains Medicaid days outstanding in accounts receivable as outlined on monthly Accounts Receivable Metrics.
- Responsible for generating private pay and co-pay bills to patients and maintains corresponding accounts receivable.
- Assists Patient Financial Services (PFS) Director with reviewing patient financial assistance forms and performs follow-up when requested.
- Performs NorthStar Palliative Care insurance verification.
- Responds timely to all patient tasks entered EMRS.
- Provides back-up assistance for other members of the PFS team including but not limited to submitting Medicare notice of elections (NOEs).
- Maintains efficient filing system.
- Attends and provides administrative and clerical support for Department meetings as required.
- Copies, faxes, scans and/or emails various documents as needed to support the efficient day-to-day operations of the Department and forwards and/or files information appropriately.
- Proactively problem solves, anticipates needs, and initiates solutions and follow up between internal and external customers necessary to ensure successful department operations.
- Utilizes allocated supplies and resources appropriately to ensure business outcomes are met.
- Adjusts to changes in workload and schedules based on changing departmental and organizational priorities.
- Participates in internal and external education, meetings, training, in-services, and other activities to promote personal and professional growth.
- Assists in the development of policies and procedures that will promote effective and efficient operations.
- Promotes knowledge of palliative care and hospice philosophies and articulates and promotes NorthStar Care Community’s vision, mission, and values within the community.
- Adheres to organizational Code of Conduct, policies, procedures, protocols and processes and all regulatory and legal requirements.
- Adheres to the NorthStar standards to care for every person, every time, 100% of the time.
- Qualifications:
- High School diploma required. Three (3) to five (5) years’ experience in healthcare government / third party billing / follow-up preferred.
- Must be able to read, write and speak English fluently and be able to communicate orally and in writing in internal and external relationships for all essential job functions.
- Must be well-organized, possess good judgment, initiative, follow through, attention to detail and ability to maintain confidential information.
- Must be computer literate, with proficiency in Microsoft Office Applications (MS Word, Excel, and Outlook) preferred. Experience with Netsmart EMR a plus.
- Must possess the ability to work in a fast-paced environment and be a self-starter who acts independently. Must possess a multi-task skillset while maintaining a high degree of efficiency and accuracy.
- Must possess critical thinking, trouble shooting and process improvement skills and be goal oriented.
- Proven ability to work effectively with other staff members and as a team player.
Job Type: Full-time
Benefits
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
- Work from home
Schedule
- Monday to Friday
Ability to commute/relocate
- Southfield, MI 48034: Reliably commute or planning to relocate before starting work (Required)
Work Location: Hybrid remote in Southfield, MI 48034
Report this job