Senior Billing Specialist

Dover Health is a part of The Dover Companies, a vertically integrated healthcare organization established in 2007, which also includes Cedarhurst Senior Living, Dover Development, Brahms Construction, and Dover Capital. Focused on providing comprehensive healthcare services to seniors, Dover Health aims to bridge the gap between traditional medical care and the evolving needs of aging populations through services such as home health, hospice care, private duty services, and primary care. Aligned with the mission of The Dover Companies, Dover Health is committed to creating an environment where each person feels loved, valued, supported, and able to live life to the fullest. Dover Health is committed to enhancing the quality of life for seniors by delivering patient-centered care that allows them to remain in their own homes with dignity and comfort.

Position Summary:

The Senior Billing Specialist, reporting directly to the Revenue Cycle Manager, is responsible for end-to-end hospice billing and revenue cycle functions, with a strong focus on Medicare compliance, claim accuracy, and timely cash collections. This role ensures clean claim submission, proactive denial management, and consistent cash flow by owning the billing process from charge entry through payment posting and AR follow-up.

Essential Duties:

The following duties are normal for this position. This list is not to be construed as exclusive or all inclusive. Other duties may be required and assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Prepare, review, and submit hospice claims (Medicare, Medicare Advantage, Medicaid, and commercial) with high accuracy and timeliness
• Ensure all claims meet hospice billing requirements (e.g., NOE, NOTR, rev codes, levels of care, sequencing)
• Monitor claim status and aggressively follow up on unpaid or denied claims, especially 60 and 90 days
• Maintain in-depth knowledge of Medicare hospice billing rules, including election statements, benefit periods, caps, levels of care (Routine, GIP, Respite, Continuous Care), face-to-face requirements and physician certifications
• Ensure compliance with all CMS billing regulations and documentation standards
• Investigate, resolve, and appeal denied or underpaid claims
• Identify root causes of denials and implement corrective actions to prevent recurrence
• Maintain accountability for AR aging and drive reduction in outstanding balances
• Post all cash receipts, adjustments, and contractual allowances accurately and timely
• Reconcile payments to billed amounts and investigate discrepancies
• Support month-end close processes, including charge entry and reconciliation
• Verify insurance coverage and patient responsibility prior to billing
• Obtain and track authorizations where required
• Conduct routine billing audits to ensure accuracy and regulatory compliance
• Identify risk areas that could lead to denials, recoupments, or audit exposure
• Maintain strict adherence to HIPAA and patient confidentiality standards
• Monitor key billing KPIs (clean claim rate, denial rate, AR aging, days to bill, cash collections)
• Recommend and implement process improvements to increase efficiency and cash flow
• Collaborate with clinical, intake, and leadership teams to resolve documentation or workflow issues impacting billing

Qualifications, Education and/or Experience:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and abilities required.

• Associate’s or Bachelor’s degree in Healthcare Administration, Accounting, or related field is preferred
• 3–5+ years of healthcare billing experience, with direct hospice billing, required
• Strong knowledge of Medicare hospice billing rules and regulations, required
• Experience with EMR/RCM systems and electronic claims submission, required
• Proven experience managing AR, denials, and collections, required
• Experience in both Hospice and Home Health billing is preferred
• Familiarity with Medicare Administrative Contractors (MACs) and payer portals is preferred

Working Conditions:

As part of Dover Health’s commitment to providing outstanding care and support, the company ensures that staff work under conditions that prioritize safety, collaboration, and professional growth. The conditions listed below define the experience of working for Dover Health.

• This position may involve a range of physical activities, including those outlined in the Essential Duties, but is not limited to them
• While performing the duties of this job, the employee is occasionally required to stand for extended periods of time, move, communicate, and identify written information. The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl and lift and/or move up to twenty (20) pounds independently
• Travel is not anticipated for this role
• This position requires the employee to be present at the corporate office daily. The role involves working at a desk for most of the workday. 
• This position may need to move through areas of the corporate office or other worksites of the organization
• This role involves actively participating in all staff activities aimed at fostering teamwork, unity, and morale. The individual will contribute as a collaborative team player, working alongside colleagues to create a supportive and cohesive work environment
• Individuals in this position are required to stay current on all training and ongoing education initiatives. They are expected to actively pursue self-improvement and embrace opportunities for continuous learning to enhance their skills and knowledge in providing exceptional service

We are an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, we will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective employees and incumbents to discuss potential accommodations with the employer.

Dover Health considers the health and safety of its patients, family members, and team members as its highest priorities. All offers of employment are contingent upon the successful completion of a background check and drug screening, participation in required health assessments (such as TB testing or physical evaluations), and the use of designated personal protective equipment (PPE) as required by company policy and applicable law.