BILLING MANAGER FOR HOME HEALTH

Brockton HHA; Brockton (MA); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Brockton Home Health Care Agency in Brockton, MA is seeking a Billing Manager to oversee day-to-day billing and claims activities. The role focuses on preparing, reviewing, and submitting claims to Medicare, MassHealth/Medicaid, managed care organizations, and other payers, researching denied claims, and ensuring timely, accurate billing.

Experience with accounts receivable follow-up and appeals is preferred, with emphasis on resolving unpaid or rejected claims and maintaining proper

Qualifications

• Experience managing billing and claims activities
• Experience with Medicare MassHealth/Medicaid and managed care organizations
• Ability to research rejected/denied claims and submit appeals

Responsibilities

• 1) Claims Preparation & Submission: prepare and submit claims accurately within payer deadlines; verify demographics, insurance info, dates of service, authorization, and codes; submit electronic and manual claims; ensure acceptance and correct re submissions; maintain documentation.
• 2) Denial & Rejection Management: own denied and rejected claims from identification through resolution; follow up on unpaid or rejected claims and pursue appeals as needed.

Job description

BROCKTON HOME HEALTH CARE AGENCY

BILLING MANAGER

Department: Administration
Position: Billing Manager
Employment Status: Full-Time
Reports To: Administrator
Location: Brockton, Massachusetts

POSITION SUMMARY

Brockton Home Health Care Agency is seeking an experiencedand detail-oriented Billing Manager to manage the agency’s day-to-daybilling and claims activities.

The Billing Manager is responsible for preparing, reviewing,and submitting accurate claims to Medicare, MassHealth/Medicaid, managed careorganizations, and other contracted payers. This position will also researchrejected and denied claims, correct billing errors, submit corrected claims andappeals when appropriate, monitor outstanding accounts receivable, and followclaims through final resolution.

The primary goal of this position is to ensure that allproperly authorized and documented services are billed accurately and on time,and that every unpaid, rejected, or denied claim receives appropriatefollow-up.

ESSENTIAL RESPONSIBILITIES

1. Claims Preparation & Submission

• Prepareand submit claims accurately and within required payer deadlines.
• Reviewclaims before submission for completeness and accuracy.
• Verifypatient/member demographics, insurance information, dates of service,authorization, units, service codes, modifiers, and other required billinginformation.
• Submitelectronic and manual claims as required by individual payers.
• Ensureclaims are accepted by the payer or clearinghouse after submission.
• Correctrejected claims promptly and resubmit them.
• Preventduplicate or inappropriate billing.
• Maintaindocumentation of claim submission and correction activity.

2. Denial & Rejection Management

The Billing Manager will take ownership of denied andrejected claims from identification through resolution.

Responsibilities include: