Pre-Bill Review Specialist: Precision & Compliance Expert

Pennant Group; Nashville (TN); In loco; USD 42.000 - 65.000; Tempo pieno

Descrizione del lavoro

Pennant Group is seeking a detail-driven Pre-Bill Review Specialist to audit patient charts before claims submission. You will verify documentation, authorizations, and payer requirements to prevent denials and accelerate reimbursement across Home Health and Hospice programs.

Collaborate with clinical, scheduling, and billing teams, ensuring compliance with Medicare/Medicaid and internal policies while maintaining up-to-date knowledge of regulatory requirements.

Competenze

• 1+ year experience in Home Health or Hospice documentation review, QA, billing, or coding
• Familiarity with Medicare/Medicaid, payer documentation requirements
• Experience with EMR systems and workflow queues

Mansioni

• Perform comprehensive pre-billing audits of Home Health and Hospice charts for completeness and accuracy
• Verify visit notes, orders, OASIS, certifications, and recertifications are signed, dated, and compliant
• Approve administrative records pre-billing and escalate abnormal results to Clinical Director
• Oversee clinical records system usage and stay updated on upgrades
• Validate patient eligibility, coverage, and authorizations before claim release
• Ensure documentation complies with federal/state regulations and internal policies
• Collaborate with clinical, scheduling, and billing teams to resolve gaps
• Provide timely feedback on documentation discrepancies to ensure efficient workflow

Descrizione del lavoro

Pennant Group is seeking a detail-driven Pre-Bill Review Specialist to audit patient charts before claims submission. You will verify documentation, authorizations, and payer requirements to prevent denials and accelerate reimbursement across Home Health and Hospice programs.

Collaborate with clinical, scheduling, and billing teams, ensuring compliance with Medicare/Medicaid and internal policies while maintaining up-to-date knowledge of regulatory requirements.