Billing & Reconciliation Representative

About the role

The Billing & Reconciliation Representative 2 determines discrepancies between company records and the records of Center for Medicare and Medicaid Services. You will perform varied assignments, activities and moderately complex administrative/operational/customer support.

Responsibilities

• Reconcile accounts each month, documenting any problems found during reconciliation, and provide appropriate plans to lead to their resolution.
• Update all interested parties continually about the status of their account, providing exceptional customer service.
• Correct enrollment and cash posting discrepancies as they relate to billing.
• Prepare documents to inform management, market groups, and regional personnel of the status of account issues.
• Decisions typically focus on interpretation of area/department policy and methods for completing assignments.
• Work within defined parameters to identify work expectations and quality standards, but have some latitude over prioritization/timing, and works under minimal direction.
• Follow standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Required Qualifications

• Bilingual (English and Spanish); with the ability to read, write, and speak in both languages with no limitations or assistance. (Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.)
• One (1) or more years of healthcare billing, accounts receivable, revenue cycle, or reconciliation experience.
• Experience with payment posting and account reconciliation.
• Proficiency in Microsoft Office, specifically Excel.
• Knowledge of insurance claims processing, including Medicare, Medicaid, and commercial payers.
• Knowledge of ICD-10, and HCPCS coding concepts.

Work Schedule

Monday – Friday; 8:00am – 5:00pm Eastern Time (ET). This is an Office-based position in Humana's One Homecare Solutions location in Miramar, FL.

Pay

$40,000 - $52,300 per year

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance

About OneHome

OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.

About Humana

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.