Home Health Pre-Billing Specialist

Parchomecare; Farmington Hills (MI); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

401(k) with matching

Dental insurance

Health insurance

Vision insurance

Paid time off

Job summary

Parchomecare in Farmington Hills, MI is seeking a Home Health Pre-Billing Specialist to ensure all documentation and billing requirements are completed accurately before final claim submission. You will audit admission charts, verify authorizations, coordinate with physicians and the Prior Authorization team, and support audits to minimize denials while collaborating with clinical and billing staff.

The role requires strong attention to detail, familiarity with EMR systems, and the ability to

Qualifications

• Meticulous attention to patient demographics, payer information and insurance details.
• Strong organizational skills to manage multiple audits and deadlines.
• Excellent communication with internal teams and external providers.
• Ability to work under pressure to meet submission deadlines.

Responsibilities

• Audit new admission charts for correct demographics, payer data and insurance authorization.
• Verify referral paperwork and insurance attached to patient charts.
• Monitor NOA reports to identify missing documentation affecting timely submission.
• Run EOE reports to audit visit frequency, completed visits and orders.
• Collaborate with QA Manager, clinical supervisors and billing staff to resolve documentation and ensure timely claims.
• Contact physician offices to obtain unsigned or missing orders needed for billing.
• Coordinate with Prior Authorization to confirm authorizations; escalate denials for follow-up.
• Review billing team messages about rejected/returned claims and resubmit as needed.
• Help organize audit requests and prepare documentation for audits.

Skills

Attention to detail

Organizational skills

Interpersonal communication

Working under pressure

Education

High school diploma or equivalent

Associate degree or healthcare certification preferred

Tools

WellSky (Kinnser)

Job description

The Home Health Pre-Billing Specialist is responsible for ensuring all documentation and billing requirements are completed accurately and on time before final claim submission. This role is critical to staying compliant with payer guidelines and minimizing billing delays and denials.RESPONSIBILITIESAudit all new admission charts to verify correct entry of patient demographics, payer information and insurance authorization detailsEnsure referral paperwork and insurance verification are completed and properly attached to the patient chartMonitor NOA (Notice of Admission) reports daily to identify and resolve missing documentation or issues preventing timely submissionRun EOE (End of Episode) reports and audit charts to verify visit frequency, completed visits, signed physician orders and referral documentationCollaborate with the QA Manager, clinical supervisors and billing staff to resolve outstanding documentation and ensure timely, compliant claim submissionContact physician offices directly to follow up on unsigned or missing orders needed for billingCoordinate with the Prior Authorization department to confirm authorizations; escalate denials to clinical supervisors for follow-upReview and respond to billing team messages about rejected or returned claims; investigate, resolve and resubmit as neededHelp organize incoming audit requests and prepare and submit documentation for internal, payer or regulatory auditsPerform additional duties as assigned by the Administrator or Director of Clinical ServicesWORKING ENVIRONMENTWorks in the Agency office. Reports to the Director of Clinical Services. Moderate lifting, with regular bending, lifting and standing.BENEFITS401(k) with matching, dental, health and vision insurance, and paid time off.High school diploma or equivalent required; associate degree or healthcare certification preferred2+ years of experience in home health billing, chart auditing or medical records review preferredKnowledge of Medicare/Medicaid regulations, PDGM and home health billing requirements preferredFamiliarity with EMR systems such as WellSky (Kinnser)Excellent organization and attention to detail; able to work under pressure to meet deadlinesStrong interpersonal and communication skills with internal teams and external providers