Billing Representative, Hospice

TridentCare

. Process and submit hospice-related claims in accordance with Medicare, Medicaid, and payer billing guidelines .

Posted 9/23/2026full-timeRemote • United StatesJuniorMid-Level💰 $18 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare billing processes, particularly in Medicare and hospice-related claims, ensuring compliance with regulations and effective denial management. Proficient in collaborating with various stakeholders to enhance billing accuracy and reimbursement outcomes.

Highest-signal resume keywords

Medicare Claims ProcessingHospice Billing RegulationsDenial ManagementB9 Denial ProcessingBilling Systems Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Healthcare Billing ExperienceClaims SubmissionModifier GW KnowledgeReimbursement RecoveryMedical Documentation InterpretationRevenue Cycle PrinciplesCompliance Requirements UnderstandingAudit SupportDocumentation MaintenanceClaim Resolution Procedures

Soft Skills

Analytical SkillsOrganizational SkillsProblem-Solving SkillsCustomer Service SkillsInterpersonal Skills

Tools & Technologies

Billing SystemsMicrosoft ExcelMicrosoft Outlook

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

CMS RegulationsHIPAA CompliancePayer Billing GuidelinesHospice ProvidersSkilled Nursing Facilities

About the role

Key responsibilities & impact

Process and submit hospice-related claims in accordance with Medicare, Medicaid, and payer billing guidelines
Submit claims with appropriate modifiers, including the GW modifier for services unrelated to the patient's terminal hospice diagnosis
Review claim submissions for accuracy and completeness
Verify payer information and billing requirements for correct claim routing and reimbursement
Research, analyze, and resolve B9 denial claims
Submit claims to appropriate hospice payers for reimbursement when required
Document denial resolution activities and payer communications in the billing system
Review correspondence, medical documentation, and supporting records to determine whether services are related or unrelated to the patient's hospice diagnosis
Coordinate with hospice providers and clinical staff to obtain supporting documentation
Maintain documentation supporting billing and reimbursement decisions
Ensure proper financial responsibility is assigned based on determination outcomes
Ensure hospice facilities receive accurate and timely charges on client invoices
Bill charges back to skilled nursing facilities when financially responsible
Ensure all billable services are invoiced appropriately
Maintain timely turnaround of bill-back activities with proper invoice notes
Enter detailed, accurate, and compliant account notes and maintain complete audit trails
Save, organize, and retain supporting documentation in accordance with company policies and regulatory requirements
Review documentation before claim submission, invoicing, and reimbursement processing
Support internal and external audits with requested documentation and claim history records
Adhere to CMS, HIPAA, Medicare, and organizational compliance requirements
Collaborate with billing leadership, hospices, facilities, payers, Sales Teams, and internal departments to improve efficiency and reimbursement outcomes
Maintain productivity, quality, and compliance standards
Support coworkers, share best practices, and contribute to department goals
Perform other related duties and projects as assigned

Requirements

What you’ll need

High School Diploma or GED required
Minimum of 2-3 years of healthcare billing experience required
Experience with Medicare claims processing, billing to appropriate hospice payers, denial management, and reimbursement recovery preferred
Experience working with skilled nursing facilities and hospice providers preferred
Hospice billing experience is a plus but not required
Strong knowledge of Medicare hospice billing regulations and reimbursement guidelines
Understanding of GW modifier requirements and hospice-related billing practices
Knowledge of B9 denial processing and claims resolution procedures
Experience billing and submitting claims to the appropriate hospice payer
Ability to interpret medical documentation and determine related versus unrelated hospice services
Strong understanding of healthcare billing and revenue cycle principles
Knowledge of HIPAA, CMS regulations, and compliance requirements
Excellent analytical, organizational, and problem-solving skills
Excellent customer service and interpersonal skills
Ability to communicate professionally and effectively with external customers, internal customers, hospice providers, skilled nursing facilities, clients, and Sales Teams
Strong written and verbal communication skills
Ability to collaborate effectively across departments, support team initiatives, share knowledge, and contribute to a positive work environment
Demonstrated ability to build and maintain productive working relationships with coworkers, leadership, Sales Teams, and business partners
Proficiency in billing systems, Microsoft Excel, Outlook, and other business applications
Ability to prioritize workload and meet deadlines in a fast-paced environment