Home Health Billing Specialist

Beacon HH - TN; Mount Juliet (TN); On-site; USD 30,000 - 47,000; Full time

Job summary

The Home Health Billing Specialist is responsible for performing all billing functions for the agency, ensuring claims are submitted accurately and on time to Medicare, Medicaid, and all commercial insurance carriers. This role is crucial for revenue cycle success and requires deep knowledge of complex home health and hospice billing rules.

The Billing Specialist is expected to conduct pre-billing audits, submit UB-04s/CMS-1450s, ensure correct ICD-10/CPT codes, and collaborate with the

Qualifications

• Two or more years of dedicated medical billing and claims submission experience, preferably in home health or hospice.
• Ability to submit and manage claims to Medicare, Medicaid, and commercial payers.
• Proficiency with EMR and billing systems and clearinghouses for electronic submission.

Responsibilities

• Conduct pre-billing audits to verify eligibility, authorization validity, and documentation before submission.
• Prepare and review claims (UB-04s/CMS-1450s) for Medicare, Medicaid, and commercial payers.
• Ensure correct ICD-10, CPT, and revenue codes to minimize rejections.
• Collaborate with Collections on delayed/denied payments and provide documentation for recovery.
• Communicate with accounting on cash receipts, month-end close, and billing metrics.
• Stay current on PDGM, Hospice payment rates, and related regulatory changes.

Skills

Medical billing

EMR navigation

ICD-10 coding

CPT coding

Claims submission

Denial resolution

Education

Medical Billing Certification

Tools

EMR system

Billing software

Clearinghouses

Job description

Job Title: Home Health Billing Specialist

Job Location: Mt Juliet, Spring Hill or Cookeville

Job Status: Full - Time

POSITION SUMMARY:

The Billing Specialist 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:

• Conduct thorough pre-billing audits to verify patient eligibility, authorization validity, and documentation completeness before claim submission.
• Prepare, review, and prepare claims (e.g., UB-04s/CMS-1450s) to Medicare, Medicaid, and all commercial insurance carriers for electronic submission.
• 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.
• 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.

PREFERRED KNOWLEDGE AND SKILLS:

• Formal training or certification in Medical Billing and Coding (e.g., CPC, COC, CPB).
• Experience with claims reconciliation and denial resolution.
• Exceptional attention to detail and a commitment to 100% claim accuracy.
• Strong analytical and mathematical skills for reconciliation and payment posting.
• Excellent organizational skills and the ability to manage high-volume submission deadlines.
• Proactive and persistent approach to resolving billing edits and rejections.
• Strong ethical commitment to compliance and accurate financial reporting.

SUPERVISORY RESPONSIBILITIES:

May supervise the team that manages all collections functions from payers and patients after claims have been processed.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Job may be performed at a desk and require heavy use of office equipment, including computer, tablet, and phone. Must have the reasonable ability to stand, walk, sit, use hands to finger, handle, feel, reach, balance, see, talk, hear, and drive. Must be reasonably capable of lifting over twenty (20) pounds. Minimal portion (<20%) of daily assignments may require travel to client/resident/patient locations or other work sites, via car or public transportation. Work schedule may occasionally require evening, night, holiday, or weekend assignments.

ACKNOWLEDGEMENT

I have read this job description and fully understand the requirements and notices set forth therein. I hereby accept the position and agree to perform the identified essential functions in a safe manner and in accordance with the Company’s established policies and procedures. I agree to request guidance from my Supervisor if I am unsure of how to interpret any policy. I further understand that my employment is at-will and thereby understand that my employment may be terminated at-will either by the Company or myself, and that such termination can be made with or without notice. This position consistently supports and promotes compliance with the Code of Conduct by maintaining the privacy and confidentiality of information, protecting the assets of the agency, acting with ethics and integrity, reporting non-compliance, and adhering to applicable Federal, State, and local laws and regulations, accreditation and licensure requirements (if applicable), and all policies and procedures.

The Pennant Group, Inc.

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.

At Beacon, we shine as a trusted guide for Tennessee families seeking healing and comfort at home.

Just as a beacon provides light and direction, our caregivers bring clarity, encouragement, and skilled expertise to patients recovering from illness, surgery, managing chronic conditions, or navigating life’s final chapters with dignity. Rooted in Tennessee’s values of resilience, family, and community, we deliver more than care — we deliver life-changing service that helps patients regain independence, find strength, and experience peace where they feel most secure: at home.

Equal Opportunity Statement

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.