Hospice Facility Biller

The Hospice Facility Biller is responsible for the accurate and timely preparation, submission, and follow-up of hospice facility claims to Medicare, Medicaid, private insurance, and other third-party payers in accordance with federal and state regulations, especially those applicable in Nevada. This role ensures the facility receives proper reimbursement for hospice services provided, while maintaining compliance with billing guidelines and organizational policies.

Key Responsibilities:

• Prepare and submit hospice facility claims using appropriate billing codes (UB-04 forms) to Medicare, Medicaid (Nevada DHCFP), and other insurance companies.
• Verify patient eligibility and benefit coverage using systems such as Availity, Nevada Medicaid Provider Web Portal, and commercial payer portals.
• Review documentation to ensure services billed meet all regulatory requirements for hospice care under CMS and Nevada state guidelines.
• Monitor claim rejections and denials; initiate timely corrections, appeals, or re-submissions as needed.
• Track aging accounts receivable and ensure prompt follow-up on unpaid claims.
• Work closely with clinical staff, intake coordinators, and case managers to ensure accuracy of billing documentation.
• Reconcile payments, post remittances, and resolve discrepancies in coordination with finance.
• Stay up-to-date on Nevada Medicaid hospice regulations and CMS billing updates.
• Assist with audits, reports, and compliance reviews related to hospice billing.
• Maintain patient confidentiality in compliance with HIPAA and company policy.

Required Skills and Qualifications

• Minimum 2 years of experience in hospice billing or long-term care billing.
• Knowledge of hospice regulations including Medicare Conditions of Participation (CoPs) and Nevada Medicaid guidelines.
• Proficiency in billing software (e.g., Kinnser, Axxess, MatrixCare, or similar).
• Familiarity with CPT, HCPCS, ICD-10, and revenue codes.
• Strong understanding of EOBs, remittance advice, and denial management.
• Strong attention to detail, organization, and time management skills.
• Effective written and verbal communication skills.
• Ability to work independently and collaboratively in a fast-paced environment.
• Familiarity with HIPAA regulations and patient privacy requirements.
• Basic office skills, including typing, computer use, faxing, and electronic data entry