Medical Claims Specialist – Hospice

Job Summary:
Responsible for the accurate and timely processing of medical claims for hospice services, including verifying insurance benefits, billing Medicare, Medicaid, and private insurance, and ensuring compliance with hospice regulations. Collaborates with clinical and administrative staff to resolve billing discrepancies and supports the financial health of the organization.

Key Responsibilities:

• Submit claims to Medicare, Medicaid, and private insurance carriers in compliance with hospice billing guidelines.

• Review and verify patient insurance coverage, authorizations, and eligibility.

• Monitor claim status and follow up on unpaid or denied claims to ensure timely reimbursement.

• Research and resolve claim rejections or payment discrepancies in coordination with billing, clinical, and intake teams.

• Accurately post payments, adjustments, and denials into the billing system.

• Maintain up-to-date knowledge of Medicare Conditions of Participation (CoPs) and payer-specific hospice billing rules.

• Assist with month-end reporting and reconciliation of accounts receivable.

• Communicate with insurance representatives, patients, and caregivers regarding billing inquiries.

• Ensure all documentation and billing complies with HIPAA, CMS, and other regulatory standards.

Qualifications:

• High school diploma or equivalent (associate or bachelor’s degree preferred).

• 2+ years of medical billing or claims processing experience, preferably in hospice or home health.

• Strong knowledge of Medicare/Medicaid hospice billing, CPT/HCPCS coding, and payer requirements.

• Experience with EMR systems and billing software (e.g., Brightree, Axxess, or Homecare Homebase).

• Excellent attention to detail, problem-solving, and communication skills.

• Ability to manage multiple tasks and meet deadlines in a fast-paced environment.

Ascendo is a certified minority owned staffing firm, and we welcome and celebrate diversity. Ascendo is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, parental status, military service or any other characteristic protected by federal, state or local law.

Contact information

Amber Kemp