Pre-Bill Review Auditor — Accuracy & Compliance

Pinnacle Senior Living; Nashville (TN); On-site; USD 52,000 - 80,000; Full time

Job summary

The Pennant Group, Inc. is seeking a detail‑driven Pre‑Bill Review Specialist in Nashville to audit patient charts before claim submission. The role focuses on ensuring documentation completeness, approvals, and payer requirements to prevent denials and speed reimbursements.

You will collaborate with clinical and billing teams to resolve documentation gaps, verify eligibility, and maintain compliance with Medicare/Medicaid and applicable regulations across home health and hospice programs.

Qualifications

• Minimum of 1 year of experience in Home Health or Hospice documentation review, QA, billing, or coding.
• Understanding Medicare, Medicaid, Government, and Commercial payer documentation requirements.
• Experience working within an EMR and familiarity with workflow queues, chart audits, and documentation compliance.
• Knowledge of corporate business management and governmental regulations.
• Demonstrates good communication skills and public relations skills.

Responsibilities

• Perform detailed pre billing audits to verify documentation completeness and accuracy.
• Confirm that visit notes, orders, authorizations, and assessments are signed, dated, and compliant.
• Complete administrative record audits and forward abnormal results for clinical audit.
• Supervise the use of the clinical records information system and stay current with upgrades.
• Validate patient eligibility, insurance coverage, and pre-billing authorizations.
• Identify missing or non‑compliant documentation and resolve deficiencies prior to billing.
• Maintain compliance with state/federal regulations and payer requirements.
• Communicate effectively with staff to coordinate care expectations and deadlines.

Skills

Chart audits

Medicare/Medicaid knowledge

EMR systems

Regulatory compliance

Communication skills

Tools

Home Care Home Base (HCHB)

Mosai

Forcura e-fax

Job description

The Pennant Group, Inc. is seeking a detail‑driven Pre‑Bill Review Specialist in Nashville to audit patient charts before claim submission. The role focuses on ensuring documentation completeness, approvals, and payer requirements to prevent denials and speed reimbursements.

You will collaborate with clinical and billing teams to resolve documentation gaps, verify eligibility, and maintain compliance with Medicare/Medicaid and applicable regulations across home health and hospice programs.