Billing Coordinator

The Pennant Group; United States; On-site; USD 52,000 - 70,000; Full time

Job summary

The Pennant Group, Inc. seeks a Billing Coordinator to manage end-to-end billing for home health and hospice services. You will ensure accurate claim submission and timely cash posting in the EMR system.

You will stay current on PDGM and Hospice rules, work with the Accounting and Collections teams, and support process improvements across revenue cycle.

Qualifications

• Two years of medical billing/claims submission experience.
• Experience in home health or hospice billing preferred.
• Ability to submit/manage claims to Medicare/Medicaid and commercial payers.
• Proficient in EMR navigation and clearinghouse submissions.
• Strong knowledge of ICD-10, CPT, and revenue codes.

Responsibilities

• Prepare, review, and submit institutional claims to Medicare/Medicaid and private payers electronically.
• Post all payments, adjustments, and denials to patient accounts in the EMR.
• Ensure ICD-10, CPT, and revenue codes on claims meet payer requirements.
• Collaborate with Collections on delayed/denied accounts with supporting documentation.
• Perform pre-billing audits for eligibility, authorization validity, and documentation completeness.
• Coordinate with Accounting on cash receipts and month-end close metrics.
• Stay current on PDGM and Hospice payer rules and update claims accordingly.
• Handle other tasks and special projects as assigned.

Skills

Medical billing

Claims submission

Home health billing

EMR proficiency

ICD-10 knowledge

CPT knowledge

Revenue codes

Tools

EMR system

Billing software

Clearinghouses

Job description

POSITION SUMMARY

The Billing Coordinator is responsible for performing all billing functions for the agency, ensuring claims are submitted accurately and on time to all payers. This role is crucial for revenue cycle success and requires deep knowledge of complex home health and hospice billing rules.

ESSENTIAL RESPONSIBILITIES AND DUTIES INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING:

• Prepare, review, and accurately submit institutional claims (e.g., UB-04s/CMS-1450s) to Medicare, Medicaid, and all commercial insurance carriers via electronic submission.
• Post all insurance and patient payments, adjustments, and denials to the correct patient accounts in the EMR system, ensuring timely and accurate reconciliation.
• Ensure the correct use of ICD-10 diagnosis codes and revenue codes on all claims to comply with payer requirements and minimize claim rejections.
• Work closely with the Collections team (or perform initial follow-up) on accounts where payment has been delayed, short-paid, or denied, providing necessary documentation to facilitate recovery.
• Conduct thorough pre-billing audits to verify patient eligibility, authorization validity, and documentation completeness before claim submission.
• Communicate effectively with the accounting department regarding cash receipts, month-end closing procedures, and reporting on key billing metrics.
• Stay current on all federal and state regulations, including the Patient-Driven Groupings Model (PDGM) for Home Health and the Hospice payment rates, ensuring claims reflect the latest changes.
• Other appropriate services and special projects as assigned.

QUALIFICATIONS & REQUIREMENTS FOR THE POSITION:

• At least two (2) years of dedicated experience in medical billing and claims submission, with a strong preference for experience in home health or hospice billing.
• Proven ability to submit and manage claims to Medicare, Medicaid, and commercial insurance.
• Proficiency in navigating an Electronic Medical Record (EMR) and billing system and utilizing clearinghouses for electronic claim submission.
• Solid working knowledge of ICD-10, CPT, and revenue codes as they relate to home health and hospice services.

The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com.

Something that sets Synergy Shared Services apart from other companies is the quality of our most valuable resources - our people! We are dedicated to living out our culture as defined by our core values, "CAPLICO": Customer Second Accountability Passion for Learning Love One Another Intelligent Risk Taking Celebrate Ownership By incorporating these principles at all levels of our organization, our employees feel valued and excited about their impact on our service center team members and operational partners. Our culture fosters excellence both personally and professionally and promotes development that leads to continued success.

We are an equal opportunity employer committed to ensuring that all conditions and privileges of employment, including recruitment, hiring, evaluation, transfer, promotion, discipline, determination of compensation and/or benefits, and termination of employment, for all job classifications, are based on qualifications and work record. No employment decision is made, nor do we discriminate, on the basis of race, color, religion, creed, sex/pregnancy, sexual orientation, gender identity, gender expression, age, national origin, ancestry, citizenship, veteran status, or disability.