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LeeHealthCareers

Career Paradise

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

Insurance Claims Specialist

Job Details

Location:
Cape Coral, FL 33990

Category:
Patient Billing

Type:
Full Time

Schedule:
Days

Job Ref:
9070

Location: Santa Barbara Professional Center

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Department: Patient Business Office

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Workdays/Nights: Days

224 Santa Barbara Blvd

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Shift: Shift 1

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

Cape Coral, FL 33991

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Work Type: Full Time

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Exempt: No

Job Summary

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

Responsibilities:

Educational Requirements

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

Experience Requirements

Minimum Years RequiredArea of ExperienceRequired/
Preferred
and/or
1 YearBilling/InsuranceRequired

State of Florida Licensure Requirements

LicensesRequired/
Preferred
and/or
Not Required

Certifications/Registration Requirements

Certificates/RegistrationsRequired/
Preferred
and/or

US:FL:Cape Coral



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