Medical Biller
Full Time • Southfield
Replies within 24 hours
Benefits:
- 401(k)
'
St. Marie's Hospice is seeking a experienced medical biller for its tea. Th
Benefits/Perks
St. Marie's Hospice is seeking a experienced medical biller for its tea. Th
Benefits/Perks
- Competitive Compensation
- Great Work Environment
- Career Advancement Opportunities
Job Summary
The Medical Biller is responsible for the accurate and timely submission of hospice claims in compliance with Medicare, Medicaid, and other payer regulations. This position plays a critical role in maintaining cash flow, regulatory compliance, and financial integrity for the organization.
The Medical Biller will manage all aspects of the billing cycle, including Notice of Election (NOE) filings, claims submission (UB-04), payment posting, denial management, accounts receivable follow-up, and hospice cap tracking. The ideal candidate has direct experience with Medicare hospice billing requirements and understands the regulatory framework governing hospice reimbursement.
This role requires strong attention to detail, knowledge of CMS Hospice Conditions of Participation, and the ability to work collaboratively with clinical and administrative staff to ensure documentation supports clean claim submission.
Responsibilities
- Medicare & Payer Billing
- Prepare and submit accurate hospice claims (UB-04) to Medicare, Medicaid, and commercial payers.
- Ensure timely filing of Notices of Election (NOE) and Notices of Termination/Revocation (NOTR/NOR) in accordance with CMS regulations.
- Verify eligibility and benefits prior to billing.
- Review clinical documentation to ensure compliance with billing requirements.
- Monitor and reconcile daily census to ensure accurate billing cycles.
- Prepare and submit accurate hospice claims (UB-04) to Medicare, Medicaid, and commercial payers.
- Revenue Cycle Management
- Track and manage Accounts Receivable (A/R).
- Follow up on unpaid, denied, or rejected claims in a timely manner.
- Investigate and resolve billing discrepancies and payer rejections.
- Post payments and adjustments accurately.
- Monitor timely filing limits to prevent lost revenue.
- Track and manage Accounts Receivable (A/R).
- Hospice Compliance & Cap Monitoring
- Monitor hospice aggregate cap and inpatient cap reporting.
- Track benefit periods and certification timelines to prevent billing errors.
- Ensure documentation supports level-of-care billing (Routine Home Care, Continuous Care, General Inpatient, Respite).
- Maintain compliance with CMS Hospice Conditions of Participation.
- Monitor hospice aggregate cap and inpatient cap reporting.
- Reporting & Financial Oversight
- Generate weekly and monthly billing and A/R reports.
- Track clean claim rate and identify trends in denials.
- Assist leadership in forecasting revenue.
- Support audit preparation and respond to Additional Documentation Requests (ADRs).
- Generate weekly and monthly billing and A/R reports.
- Collaboration & Communication
- Work closely with clinical staff to ensure documentation supports claims.
- Communicate with families regarding billing inquiries when appropriate.
- Coordinate with intake and admissions staff to confirm payer authorization.
- Report potential compliance risks to leadership promptly.
- Work closely with clinical staff to ensure documentation supports claims.
- Administrative Duties
- Maintain organized billing records and electronic documentation.
- Stay current on Medicare and Medicaid billing updates and regulatory changes.
- Participate in compliance training and internal audits.
- Maintain organized billing records and electronic documentation.
Qualifications
- Strong customer service skills
- 3 years medical billing required / hospice billing preferred
- Strong organization skills
- Excellent attention to detail
Compensation: $45,000.00 per year
OUR HISTORY
St. Marie’s Hospice has been serving diligently servicing the Detroit tri-county area as a full-service hospice for more than a decade.
With deep roots in the Detroit community, our professional staff of physicians, registered nurses, LPNs, certified nursing assistants, social workers, musical therapists, and chaplains are experts in end-of-life care, offering family and caregiver support, non-medical therapies, and bereavement services.
We care for our patients wherever they reside.
Our compassionate and generous volunteers offer companionship and support. Since we first began offering services to the community, we have specially trained our volunteers in hospice care. Our staff and volunteers alike approach each patient and family with the values we all hold dear – respect, dignity and a celebration of life.
Our philosophy has always been to help patients remain independent for as long as possible. Our caregivers engage the patient and family to develop an individualized plan of care, with the Hospice team by the patient’s side for guidance, support, and treatment.
Most of our patients receive hospice benefits under Medicare, Medicaid, or private insurance. As a non-profit hospice, we have always cared for any patient who needs and wants our services; it is at the core of who we are. All patients who are eligible for hospice services may receive care from St. Marie’s Hospice.
(if you already have a resume on Indeed)