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Role Description

At VitalCaring, our team members transform lives and foster hope through genuine caring. The Hospice Billing Specialist plays a vital role in supporting the financial integrity of our hospice operations by ensuring accurate and timely billing in compliance with Medicare Hospice regulations and all applicable federal, state, and commercial payor requirements.

• 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)
  • 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.

Qualifications

• 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

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