Quality and Billing Specialist

Celebrated as the #3 Top Workplace in the D.C. region for 2025 by The Washington Post since 2019, Goodwin Living is more than a team – it's a global family of individuals who represent more than 70 countries.

Goodwin Living is proud to be recognized as a Top Workplace in the greater Washington, D.C. region by The Washington Post every year since 2019 — and now nationally by USA Today. Since 2022, we’ve also been annually recognized as one of the top 100 employers for interns by the Top Virginia Employers for Intern Awards. These honors are based entirely on feedback from our team members, gathered through an annual third-party survey. Here’s what they say makes us stand out:

• Embracing Diversity: Our strength is in our diverse team from over 65 countries, fostering an inclusive and vibrant culture that values every voice. 
• Growth and Opportunities: We bolster personal and professional development, offering myriad opportunities, from on-the-job training to mentorship programs and financial support, to help you reach your full potential. 
• Valuing Our Team Members: By prioritizing team member satisfaction, we create a fulfilling work environment with competitive benefits, work-life balance, and recognition programs, ensuring our team feels appreciated and valued.  

Salary: Up to $43

About the Position

The Hospice Quality and Billing Specialist is responsible for supporting hospice operations through oversight of quality/compliance processes and accurate coordination of billing functions. This role works closely with clinical, admissions, and finance teams to ensure documentation meets regulatory requirements, claims are processed timely, and quality metrics are monitored to support agency performance and compliance.

Job Duties

1. Quality & Compliance Oversight

·         Monitor hospice documentation for regulatory compliance with CMS, CHAP, and agency standards.

·         Conduct routine chart audits for CTIs, Face-to-Face encounters, Plans of Care, visit documentation, eligibility documentation, and LCD compliance.

·         Assist with QAPI data collection, tracking, and reporting.

·         Track and trend hospitalizations, live discharges/revocations, missed visits, CAHPS opportunities, and documentation timeliness.

·         Support ADR/TPE audit preparation and tracking.

·         Collaborate with leadership to identify compliance risks and recommend corrective actions.

·         Assist with education and follow-up related to documentation deficiencies.

·         Maintain audit logs, compliance trackers, and regulatory records.

2. Billing & Revenue Cycle Support

·         Review claims for accuracy prior to billing submission.

·         Verify required documentation is complete before claims release, including NOEs, CTIs, Face-to-Face encounters, visit completion, and physician signatures.

·         Monitor claim status and follow up on rejections, RTPs, denials, and unpaid claims.

·         Coordinate with billing vendors, Medicare, Medicaid, and commercial payers as needed.

·         Assist with monthly billing close processes and revenue tracking.

·         Review eligibility and payer authorizations.

·         Support timely filing compliance and payment reconciliation.

·         Track ADRs, denials, appeals, and billing trends.

·         Generate billing and operational reports for leadership review.

3. Operational Collaboration

·         Work closely with Clinical Managers, Admissions, Billing/Finance, Compliance, and Medical Records.

·         Participate in quality and operational meetings.

·         Assist with implementation of workflow improvements and process standardization.

·         Support onboarding and education related to documentation and billing processes.

Job Requirements

• Associate’s or Bachelor’s degree preferred.
• Minimum of 2 years hospice experience required.
• Experience with hospice billing, quality, or compliance strongly preferred.
• Knowledge of Medicare hospice regulations and billing requirements.
• Experience with EMR systems such as WellSky preferred.
• Strong understanding of hospice documentation requirements and LCD guidelines.
• Proficient in Microsoft Office, Excel, and reporting tools.
• Strong organizational, analytical, and communication skills.
• Ability to manage multiple priorities in a fast-paced environment.