VitalCaring Group

Project Manager

• Provide support to the General Counsel and other Home Office stakeholders, as well as all Regional leaders and branch offices, on a variety of legal, compliance, licensure, operational and administrative matters.
• Support the Contracts Manager and Legal Assistance with overflow work for routine branch-facility contracts as well as medical records requests.
• Assist with corporate governance matters, manage corporate records, and prepare board materials, as requested.
• Submission of employee, vendor and physician information for monthly screening against federal and state sanction lists. This includes providing any follow-up information when requested in order to rule out flagged individual or organization and reporting results timely to the VP of Compliance.
• Assist with routine and time-sensitive ad hoc projects.
• Maintain updated and organized files and trackers with consistent naming conventions.
• Provide general administrative support to the Legal and Compliance departments as needed.
• Help ensure the organization complies with all relevant federal and state statutes and regulations, working closely with the Compliance team.
• Performs all other duties as assigned.

Legal and Compliance Project Manager

Insurance

• Implements and follows established company Standard Operating Procedures (SOP) regarding insurance verification and authorization department
• Responsible for employee training and mentoring, reviewing work for accuracy and efficiency, monitoring team performance
• As subject matter expert for team, answers questions and provides daily support and guidance as needed
• Hosts and documents monthly 1:1’s with direct reports to discuss performance, communicate issues, foster productive relationships, and maintain open communication with each team member
• Develops and communicates goals and objectives, documents and hosts annual performance reviews for each team member
• Provides opportunities for professional growth and development
• Perform regular audits of records for accuracy, completeness, and security
• Collaborate with clinical and administrative staff to support department success
• Identifies potential Bad Debt and reports to the Revenue Cycle Manager, Revenue Cycle Director, and Vice President, Revenue Cycle in a timely fashion
• Generate reports and statistics related to insurance verification and authorization activities, compliance, and productivity
• Works with internal and external personnel to approve and clear billing per company policy and regulatory guidelines
• Monitors workflows throughout the day to ensure timely processing
• Maintains effective, professional communication with internal and external staff including communication of frequent chart errors to the department and operational leaders
• Serves as a subject matter expert and can perform tasks the department is responsible for
• Maintains compliance with internal policies, procedures, and regulations, including federal and state laws
• Performs all other duties as assigned

Insurance Verification & Authorization Supervisor

Billing Specialist

• 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.

Hospice Billing Specialist

• Follow VitalCaring billing Standard Operating Procedures and regulatory billing guidelines
• Collaborate with your supervisor and the billing team to address payor and billing concerns
• Ensure documentation accuracy and submit claims in accordance with Medicare and other payor requirements
• Serve as a key liaison to Branch Directors and administrative staff to gather information needed for claims
• Meet individual productivity standards and maintain confidentiality of financial information
• Manage workflow tasks and documentation in our EMR system
• Upload payor communication documents and input billing Coordination Notes to support team communication
• Participate in learning and development to continue growing professionally
• Represent VitalCaring with integrity, positivity, and alignment to our mission
• Maintain compliance with federal, state, and ethical billing regulations
• Perform additional duties as assigned

Home Health Billing Specialist

Administration

• Lead and manage all referral portal platforms: maintaining configurations, service line rules, coverage areas, payor matrices, and branding.
• Ensure listing accuracy across all hospital and third-party portals by partnering with Intake, RCM, and Operations.
• Grant and manage user access & permissions while ensuring consistent workflows and communication.
• Build and deliver dashboards and reports that track referral volume, acceptance trends, response times, conversion rates, and leakage opportunities.
• Spot and solve barriers in partnership with Sales, Intake, IT, and Operations—removing roadblocks and improving workflows.
• Provide hands-on support for the Sales and Intake teams for troubleshooting, updates, and portal optimization needs.
• Drive automation and AI-supported workflows by partnering with IT and cross-functional teams.
• Maintain portal documentation including requirements, contacts, and best practices.
• Reduce manual effort through smarter configuration, standardized processes, and continuous improvement.
• Support accuracy of sales-related data in CRM, EMR, and related systems.

Sales Portal Administrator

• Conduct insurance verification through payer portals, phone calls, and HCHB’s integrated tools for all new referrals and ongoing patients.
• Initiate and obtain prior authorizations for home health services including nursing, therapy, and aide services as required by payers.
• Accurately enter and maintain insurance, authorization, and eligibility information within the HCHB system in real-time.
• Review patient intake information to ensure payer requirements are identified and addressed early in the admission process.
• Collaborate with intake, clinical staff, case managers, and billing teams to resolve authorization-related issues promptly
• Follow up proactively with insurance companies to ensure timely processing of authorizations and appeals.
• Stay current on payer-specific authorization protocols, documentation requirements, and changes to coverage policies affecting home health.
• Ensure compliance with HIPAA, Medicare Conditions of Participation, and other regulatory standards.
• Maintain organized and auditable records of all insurance and authorization communications and decisions within HCHB and agency systems

Legal and Compliance Project Manager

Insurance Verification & Authorization Supervisor

Hospice Billing Specialist

Home Health Billing Specialist

Sales Portal Administrator

Insurance Verification & Authorization Specialist