Chapters Health System

Collections

• Prepares and submits accurate billing to third party payor’s and self-pay invoices.
• Identifies and resolves billing clearinghouse rejections.
• Conducts root cause analysis on unpaid accounts receivable (AR) and resolves with third party payor’s.
• Analyzes and resolves credit balances.
• Handles incoming and outgoing customer service calls to third party payor’s, outside providers and patients/guarantors to resolve and achieve account resolution.
• Processes correspondence.
• Initiates and resolves technical denial appeals.
• Identifies payor denial and cash fluctuation trends and escalates as appropriate.
• Performs other duties as assigned.

Hospice Medicare Billing and Collections Representative

Marketing

• Responsible for increasing access to care primarily in the program they are assigned (i.e. Hospice, PACE)
• Responsible for identifying and increasing referral sources to meet organizational access to care goals reflecting the community need for the Hope’s programs and services
• Utilize various resources and educational techniques to enhance referrals
• Responsible for identifying opportunities with other health care providers to support enrollment or appropriate admission into the assigned Hope program
• Provide community education when requested or approved by direct report
• Ensure referral sources choose a Hope Healthcare program for their patients or residents

PACE Program Marketing Liaison – Bilingual, English/Spanish

Billing Specialist

• The Billing Manager is responsible for managing and coordinating the overall functions of the billing department including the submission of claims, resolution of outstanding accounts and cash flow maximization.
• In addition, the manager is responsible for remaining current on all payor policies and regulations and ensuring compliance with Medicare, Medicaid and Commercial Insurances.
• Manages the daily operations of the Billing Department including monitoring and revision of policies and procedures.
• Establishes internal controls to ensure timely and accurate billing to third party payors.
• Ensures days in accounts receivable remain at or below Company standards in addition to monitoring daily cash flow.
• Reviews monthly productivity and quality assurance (QA) reports.
• Assists with execution of third party payor and/or governmental audits.
• Creates, analyzes and presents A/R performance metrics to management.
• Performs root cause analysis to identify opportunities for process improvements and/or automation and implements new procedures.
• Performs other duties as assigned.

Billing Manager

Therapist

• Responsible for the initial assessment and ongoing assessment of patients upon referral from multi-disciplinary team.
• Evaluation of patient/family response to therapy.
• Responsible for providing and recommending therapeutic functions.
• Identify and identify problems and develop solutions.
• Develop goals as related to the needs of the patient.
• Develop treatment plan in consultation with the IDG to include the physician, including any changes or provisions.
• Revise plan of care as needed to include discharge planning and evaluation.
• Review and complete patient assessments and plan of care.
• Identify equipment required to increase the patient’s function and independence.
• Plan and develop maintenance, exercise and therapy programs for participants.
• Provide education to family members and friends for those parts of the treatment plan that they can carry out.
• Responsible for timely documentation of all therapy interventions to include assessments and evaluation data, treatments and the patient’s response to therapy intervention.
• Oversee duties of the PT/OT Aide.
• Represent the company in a positive and professional manner at all times with others, e.g., co-workers, management, vendors, and customers.
• Complete all job responsibilities in a thorough and complete manner, utilizing good judgment in all aspects of the job.
• Carry out duties and responsibilities in a manner that exemplifies excellent customer service.

Hospice Medicare Billing and Collections Representative

PACE Program Marketing Liaison – Bilingual, English/Spanish

Billing Manager

Occupational Therapist – PACE Program