HOME HEALTH BILLING & REIMBURSEMENT SPECIALIST

Responsibilities

• Manage home health billing and reimbursement activities, ensuring compliance with Medicare PPS and third-party payer requirements.
• Verify insurance coverage and maintain accurate patient billing information within the Home Health EMR.
• Submit, monitor, and follow up on claims to ensure timely and accurate reimbursement.
• Investigate and resolve claim denials, payment discrepancies, and billing inquiries.
• Post payments, adjustments, and accounts receivable transactions accurately.
• Maintain complete documentation and update records within the Home Health EMR system.
• Communicate billing issues, reimbursement delays, and payer changes to the Reimbursement Analyst.
• Generate billing and accounts receivable reports and assist with revenue cycle improvement efforts.
• Collaborate with Home Health team members and other departments to support efficient reimbursement processes.

Qualifications

• Minimum of three (3) years of experience with third-party reimbursement in a healthcare patient accounting, billing, or revenue cycle environment.
• Minimum of three (3) years of experience in healthcare billing, reimbursement, accounts receivable, or denial management.
• Home Health billing and reimbursement experience required.
• Experience working with Medicare PPS reimbursement methodologies and compliance requirements.
• Strong knowledge of third-party payer reimbursement processes, including Medicare, Medicaid, and commercial insurance plans.
• Thorough understanding of UB-92/UB-04 billing requirements and claim submission processes.
• Knowledge of ICD-9, ICD-10, CPT, and HCPCS coding principles.
• Experience with denial management, appeals, and reimbursement recovery.
• Proficiency in Microsoft Office applications, including Excel, Word, and PowerPoint.
• Demonstrated experience working in information technology environments and healthcare database management systems.
• Strong financial analysis and accounts receivable management skills.
• Ability to develop, analyze, and prepare reports related to reimbursement and revenue cycle performance.
• Exceptional attention to detail and accuracy.
• Excellent verbal, written, and interpersonal communication skills.
• Ability to manage multiple priorities, meet deadlines, and work independently.
• Strong problem-solving and critical-thinking abilities.

Pay

Entry USD $17.50/Hr. Max USD $27.13/Hr.