Billing Specialist
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Job Description
Billing Specialist managing Medicare, Medicaid, and Commercial insurance claims for home health and hospice services. Collaborating with cross-functional teams to ensure billing accuracy and compliance.
Responsibilities:
- Prepare and submit accurate Medicare, Medicaid, and Commercial insurance claims through Home Care Home Base (HCHB) and Waystar billing platforms.
- Ensure compliance with Patient-Drive Groupings Model (PDGM) billing rules and payer-specific guidelines.
- Monitor, review, and follow up on claims, including aging accounts receivable, denied or rejected claims.
- Resubmit overdue accounts and escalate seriously overdue accounts to collections when necessary.
- Collaborate with cross-functional teams including Intake, Authorization, Clinical, Operations Support Office (OSO), and regional staff to ensure billing accuracy and resolve any discrepancies.
- Respond to billing inquiries from internal and external stakeholders.
- Participate in Accounts Receivable (AR) and Billing Accountability Meetings (BAM).
- Prepare and review relevant reports such as billing summaries, bad debt, and outstanding AR to ensure accuracy and completeness.
- Assist with audits and provide documentation as needed.
Requirements:
- Bachelor’s Degree Business Administration or related field Preferred
- Minimum 2 years of billing experience in Home Health and/or Hospice.
- 2 - 5 years of experience preferably in Home Care
- Strong written and verbal communication skills
- Home Health and Hospice billing experience
- Proficiency with HCHB EMR, clearing houses such as DDE and Waystar.
- A strong understanding of Medicare, Medicaid, and commercial insurance billing.
- Excellent organizational, analytical, and communication skills.
- Ability to work independently and manage multiple priorities in a deadline-driven environment.
Benefits:
- Health insurance
- Professional development opportunities
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