• Job Description

  Req#: 3381385
  Job Type
  
  Full-time
  
  Description
  
  Our people are the difference.
  
  Transitions Care is a leading hospice organization that has changed the hospice experience for patients, families, and team members. Imagine a healthcare company that provides 24/7 access to services in the comfort of the patient's home - providing the physical, emotional, and spiritual support that allows a patient to focus on living.
  
  At Transitions, you don't have to imagine! Apply now to join our team and experience the Transitions difference!
  
  As a Hospice Senior Billing Specialist at Transitions Care you are responsible for managing the end-to-end billing process for hospice Room and Board services across multiple payors and states. This includes claim preparation and submission, payment reconciliation, denial resolution, and coordination with internal stakeholders. The role requires deep operational knowledge of Medicaid Room and Board billing, familiarity with long-term care facilities, and a proactive approach to ensuring accuracy and compliance within a fast-paced revenue cycle environment.
  
  Major Responsibilities
  
  Billing & Claims Processing
  
  • Submit accurate and timely Room and Board claims through HCHB, All Payer, and Medicaid/Commercial portals.
  • Sweep and release clean claims daily; ensure proper documentation and submission workflows are followed.
  • Utilize the LTC Report to confirm claim readiness and ensure all claim elements (service location, billing stages, etc.) are met.
  • Coordinate with branches to resolve bill holds and missing documentation affecting timely billing.
  
  Revenue Cycle & Reconciliation
  
  • Monitor and update the "Revenue Received" fields in LTC reports and reconcile payment variances.
  • Perform monthly rate reviews using state Medicaid sites; report retro/proactive changes for invoice or claim adjustments.
  • Execute adjustment invoices and track them against claim changes and LTC documentation.
  • Conduct pre-aging verification using HCHB and LTC to reduce aging rollovers.
  
  A/R & Denial Management
  
  • Review and work daily aging reports; resolve outstanding balances through follow-ups, appeals, or write-offs.
  • Handle denial management workflows by categorizing claims as Paid, Appeal, Write-Off, or In-Process.
  • Maintain and resolve all differences in the LTC report (e.g., rate mismatches, applied income discrepancies).
  
  Zero Pay & Payment Posting
  
  • Investigate and document all Zero Pay claims (Type 1-4); collaborate with remittance and cash posting staff to ensure full resolution.
  • Confirm and post Paid-Not-Posted accounts with documentation from payors and EOBs.
  
  Audit & Compliance
  
  • Audit and update the LTC report regularly to reflect accurate billing, status, and reconciliation.
  • Review R&B Roster and LTC data for consistency, accuracy, and completeness.
  • Assist with internal and external audits by maintaining remittance files, claim documentation, and EOBs.
  • Ensure all billing processes adhere to HIPAA, Medicaid, and payer-specific requirements.
  
  Communication & Collaboration
  
  • Respond promptly to internal and external emails-especially those from RCM leadership, facility reps, and provider relations teams.
  • Escalate claim trends, delays, and payer issues to the RCM Director.
  • Collaborate with Intake, Clinical, and Compliance teams for accurate service setup and workflow transitions.
  • Attend weekly RCM meetings and submit Daily Billing Reports.
  
  
  Benefits We Offer
  
  • Competitive salary
  • Medical / Dental / Vision Insurance plans
  • Life Insurance
  • 401(k) matching
  • Company Equipment
  • Paid Time Off
  
  
  Requirements
  
  Education and Experience
  
  Experience:
  
  • 3-5 years in healthcare billing; Room and Board, Long-Term Care, or hospice
  
  Medicaid billing experience required.
  
  • Experience working with government payors including Medicaid, Managed Care, and state-specific R&B policies.
  
  Education:
  
  • High school diploma required. Associate's or bachelor's degree in healthcare administration, business, or a related field preferred.
  
  Technical:
  
  • Proficiency in HCHB, All Payer, and Microsoft Excel.
  • Familiarity with LTC audit tracking and claim lifecycle management tools.
  
  Skills:
  
  • Strong analytical, organizational, and problem-solving skills.
  • Clear, timely written and verbal communication.
  • Deadline-driven with attention to billing details and claim nuances.
  
  Preferred:
  
  • Certification in Billing & Coding (CPB, CPC, or CHFP).
  • Nursing facility or long-term care exposure.
  • Pediatric or applied income billing experience

• About the company

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