Lowcountry Palliative Care

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Palliative Care Program Manager

Project Management

Full Time

Bluffton, US

Posted this week

About the Job

Salary - $60000 - $70000/Year

Palliative Care Program Manager
Hospice Care of the Lowcountry
Full-Time ($60,000 - $70,000)

Lowcountry Palliative Care is the sister company and under the umbrella of Hospice Care of the Lowcountry an independent, community-based, non-profit organization, serving Beaufort and Jasper counties for more than 40 years. We help our valued patients, and their families experience the fullness and dignity they deserve, even as they face the anxieties associated with the end of life and chronic symptom management.

Overview:
The Palliative Care Program Manager is responsible for coordination of all program aspects such as scheduling patients, taking referrals, insurance verification, claims, and payments questions/issues. Review and submit all visit charges generated by Palliative Care Practitioners for billing. Coordinate all remit denials and claims issues and complete the month end reconciliation using financial reports provided by software monthly. Other duties maybe assigned as program develops.

Palliative Care Program Manager Duties include but are not limited to:

· Verifies all insurance information prior to entering the payer in EMR/billing software and retains copies of the insurance verification.

· Review all claims encounters to ensure all information necessary is provided and accurate prior to sending a completed claim (visit charges).

· Submits to appropriately for processing all visit charges generated by PC practitioners daily.

· Reviews all alerts/task messages received for any errors/items that require review for possible correction by provider.

· Work with third party claims service to set up EDI services for claims submission.

· Review all claims encounters to ensure all information necessary is provided and accurate prior to sending a completed claim.

· Act as primary resource for third party claims service to provide feedback on all questions about payments being applied in accordance with company policy.

· Obtain access to payer websites.

· Maintain the Medicare direct data entry (DDE) process.

· Handles all request for refunds due to overpayment received with respect to any claim or bill or that any billing impropriety has occurred.

· Responsible for complying with all applicable (federal and state) laws and regulations.

· Maintain up to date fee schedules.

· Works with accountants to ensure monthly cash sheet totals for the operating account reconciles with the remits received for each financial class/payer.

Education/Experience:

Any combination of education and experience that would provide required skillsand knowledge for successful performance would be qualifying. Typical qualifications would be equivalent to:

· Minimum three (3) years’ experience as a medical biller or similar role in a (Professional) Healthcare setting.

· At least one of the following Certifications preferred: Home Health- certified coder- HCS-O, HCS-D, COS-C, or Coding Specialist Certification – Hospice (HCS-H)

· Certified Professional Coder (CPC) preferred.

· Experience with Windows, accounting software and data entry.

· Working with medical payers including, Medicare Medicaid, and commercial insurance.

· Medicare Part B billing experience preferred

Knowledge of:

· Medical Billing software and electronic medical records.

· Insurance verification process and authorization requirements.

· Insurance reimbursement guidelines including HMO/PPO, Medicare, Medicaid and other payer requirements and systems.

· Revenue cycle and how the various components work together preferred.

Job Type: Full-time

Pay: $60,000.00 - $70,000.00 per year

Benefits:

  • 401(k)
  • Dental insurance
  • Flexible schedule
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift

Supplemental Pay:

  • Bonus pay

Ability to commute/relocate:

  • Bluffton, SC 29910: Reliably commute or planning to relocate before starting work (Required)

Education:

  • Bachelor's (Preferred)

Experience:

  • Medicare Part B Billing: 3 years (Preferred)

Work Location: One location

Posted this week

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