Job Type

Full-time

Description

Our people are the difference.

Transitions Care is a leading hospice organization that has changed the hospice experience for patients, families, and team members. Imagine a healthcare company that provides 24/7 access to services in the comfort of the patient's home - providing the physical, emotional, and spiritual support that allows a patient to focus on living.

At Transitions, you don't have to imagine! Apply now to join our team and experience the Transitions difference!

As a Hospice Senior Billing Specialist at Transitions Care you are responsible for overseeing the hospice billing and accounts receivable process to ensure timely and accurate claim submission, payment posting, and revenue cycle management. This role requires in-depth knowledge of Medicare, Medicaid, and private insurance billing regulations to ensure compliance and minimize claim denials. The ideal candidate will be detail-oriented, organized, and able to effectively collaborate with internal teams and external payers.

Major Responsibilities

Billing & Claims Management:

• Prepare and submit claims to Medicare, Medicaid, and private insurance providers for hospice services.
• Review claims for accuracy, completeness, and compliance with payer guidelines.
• Monitor claim rejections and denials, initiating timely follow-ups and appeals.
• Ensure that all billing transactions are accurately recorded in the billing system.

Accounts Receivable & Collections:

• Track outstanding claims and follow up on unpaid or underpaid claims.
• Resolve billing discrepancies and reconcile payments with patient accounts.
• Generate and distribute patient statements, responding to inquiries as needed.
• Maintain accurate aging reports and work to reduce outstanding balances.

Compliance & Regulatory Oversight:

• Ensure adherence to Medicare Hospice Benefit regulations and HIPAA guidelines.
• Stay updated on changes in hospice billing policies.
• Assist with internal and external audits by providing necessary documentation.

Coordination & Communication:

• Work closely with clinical staff to ensure accurate documentation and billing.
• Communicate with insurance representatives to clarify billing requirements.
• Provide guidance and training to junior billing staff as needed.

Service Line Specifics:

• Hospice or Room and Board Background Preferred
• Knowledge and Experience in Microsoft Excel
• Accounts Payable Background Preferred
• Deadline Oriented
• Nursing Facility or Long-Term Care Experience Preferred
• Pediatric Billing Experience Preferred
• Strong in Collections for Government Payor mix Medicaid, Medicaid Managed Care

Benefits We Offer

• Competitive salary
• Medical / Dental / Vision Insurance plans
• Life Insurance
• 401(k) matching
• Company Equipment
• Paid Time Off

This position is Remote in the San Antonio, TX area.

Requirements

Education and Experience

Experience: Minimum 3-5 years of hospice or healthcare billing experience.

Education: High school diploma or equivalent required; associate's or bachelor's degree in healthcare administration, business, or a related field is preferred.

Technical Skills: Proficiency in billing software (HCHB) and electronic health records (EHR) systems.

Regulatory Knowledge: Strong understanding of Medicare, Medicaid, and private insurance billing regulations.

Soft Skills: Excellent analytical, problem-solving, and organizational skills. Ability to communicate effectively with internal teams, patients, and payers.

Preferred Qualifications:

• Experience in hospice revenue cycle management.
• Certification in Medical Billing and Coding (e.g., CPB, CPC, or CHFP).
• Experience working with third-party payers and government reimbursement programs.