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Hospice Medicare Billing and Collections Representative
Chapters Health System. Process and submit third-party claims .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing and collection processes, including third-party claims management and denial resolution. Proficient in analyzing accounts receivable and ensuring compliance with applicable regulations and policies.
Highest-signal resume keywords
Medical Billing ExperienceThird-Party Claims ProcessingDenial ManagementData Entry SkillsCommunication Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical BillingClaims SubmissionAccounts Receivable AnalysisBilling Clearinghouse ManagementRoot Cause AnalysisTechnical Denial AppealsCredit Balance ResolutionRegulatory ComplianceData EntryPrioritization
Soft Skills
Self-MotivatedService OrientedExcellent Communication
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
Third-Party BillingState and Federal Collection RegulationsQuality ImprovementConfidentialityDrug-Free Workplace Policy
About the role
Key responsibilities & impact- Process and submit third-party claims
- Manage denials and resolve accounts
- Prepare and submit accurate billing to third-party payors and self-pay invoices
- Identify and resolve billing clearinghouse rejections
- Conduct root cause analysis on unpaid accounts receivable and resolve issues with third-party payors
- Analyze and resolve credit balances
- Handle incoming and outgoing customer service calls with third-party payors, outside providers, and patients/guarantors
- Process correspondence
- Initiate and resolve technical denial appeals
- Identify payor denial and cash fluctuation trends and escalate as appropriate
- Represent the Company professionally and comply with applicable regulations, policies, and practices
- Maintain confidentiality and participate in quality improvement, research, educational, and performance activities
- Perform other duties as assigned
Requirements
What you’ll need- High School Diploma or GED
- Minimum of one (1) year of medical billing and collection experience
- Knowledge of third party billing and state and federal collection regulations preferred
- Ability to prioritize and multi-task independently with little supervision
- Must be self-motivated and service oriented
- Excellent written and verbal communication skills
- Accurate typing and data entry skills
- Satisfactorily complete competency requirements for this position
- Consent to drug and/or alcohol testing after a conditional offer of employment
- Ongoing eligibility through the Florida Care Provider Background Screening Clearinghouse
- Ongoing compliance with the Drug-Free Workplace Policy
Benefits
Comp & perks- Drug and/or alcohol testing consent and ongoing compliance with the Drug-Free Workplace Policy
- Florida Care Provider Background Screening Clearinghouse eligibility verification