Home Health Billing Specialist: Precision Claims Expert

Pennant Group; Mount Juliet (TN); Sur place; USD 30 000 - 47 000; Plein temps

Résumé du poste

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.

Responsabilités

• 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.

Connaissances

Medical billing

EMR navigation

ICD-10 coding

CPT coding

Claims submission

Denial resolution

Formation

Medical Billing Certification

Outils

EMR system

Billing software

Clearinghouses

Description du poste

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