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Career Paradise

ca·reer par·a·dise | /ke’rir ,pere’dīs/ noun

Insurance Claims Specialist

Job Details

Cape Coral, FL 33990

Patient Billing

Full Time


Job Ref:

Location: Santa Barbara Professional Center


Department: Patient Business Office


Workdays/Nights: Days

224 Santa Barbara Blvd


Shift: Shift 1


8:00:00 AM to 4:30:00 PM

Cape Coral, FL 33991


Work Type: Full Time


Exempt: No

Job Summary


The CBO Hospice representative is responsible for all Hospice election accounts. The responsibility will include adding appropriate stop bills, updating the accounts with all necessary Hospice related information and setting up the appropriate scenario split bills. Only the designated CBO Hospice Representative shall perform the split billing on these accounts and work any Hospice related edits in Epic only. The team billers should work any non-Hospice related claim edits but shall never remove the biller triggered claim edit or Hospice Stop Bill on from the account. The team billers are also responsible for working the claims in SSI. Should the biller have a concern with the claim once it reaches SSI, they can inquire via email to the CBO Hospice Representative. The team billers are also responsible for working all denials on Hospice accounts. If they identify a claim that has been billed in its entirety or Split-billed to Medicare/Medicaid/Non-Contracted Medicaid HMO and is now denying for a Hospice overlap, they must add a 1031 Stop Bill to the account and make a notation on the account of their actions and findings. The Office Hospice Representative will compile a secure e-mail using SLEE to the appropriate Hospice representative to validate Hospice election. The account will remain on the 1031 Stop Bill until Hospice Election has been identified. The e-mail which houses confirmation of the Hospice election will be scanned at the patient account level. There are specific updates needed depending on the status of the Hospice election and type of insurance a patient has; the differences are defined in the Hospice Billing and Follow-up Policy. Knowledge of Hospice Billing and Guidelines a plus.

Job Requirements


Educational Requirements

Degree/Diploma ObtainedProgram of StudyRequired/
High School Diploma or EquivalentRequiredor

Experience Requirements

Minimum Years RequiredArea of ExperienceRequired/
1 YearBilling/InsuranceRequired

State of Florida Licensure Requirements

Not Required

Certifications/Registration Requirements


US:FL:Cape Coral

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