Reimbursement Specialist (Home Health exp. Preferred)

Addus HomeCare; Frisco (TX); Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical, Dental & Vision

PTO Plan

Retirement Planning

Life Insurance

Job summary

Addus HomeCare is seeking a Reimbursement Specialist (Home Health) to drive billing and revenue cycle activities. You will investigate insurance benefits for new referrals, handle authorizations, and submit claims while coordinating with payers, patients and providers for timely reimbursement.

The role requires home health billing knowledge, EVV familiarity, and strong experience with Medicare/Medicaid regulations to ensure compliant, accurate claim processing.

Qualifications

• High school diploma or equivalent required; undergraduate degree preferred.
• 5 years of healthcare collections/billing experience preferred.
• Strong understanding of hospice billing regulations (Medicare, Medicaid, commercial).
• Ability to read and interpret EOBs, remittances, and denial codes.
• Effective payer follow-up and escalation strategies.
• Ability to resolve claim holds, rejections, and denial.
• Root-cause analysis to prevent recurring issues.
• High attention to detail to ensure clean claims.

Responsibilities

• Billing and revenue cycle management for home health referrals.
• Authorization requests and claim submissions across payers.
• Communicate with insurance companies, patients, providers and prescribers to coordinate reimbursement and access solutions.
• Review unpaid accounts to determine status and take appropriate actions to ensure payment.
• Maintain compliance with Medicare, Medicaid, HIPAA regulations and internal policies.

Skills

Healthcare billing

Home Health billing

EVV knowledge

Medicare/Medicaid billing

Payer follow-up

Data entry accuracy

Confidentiality

Communication with payers

Education

High school diploma or equivalent

Undergraduate degree preferred

Tools

MS Office

Job description

Career Opportunities with Addus HomeCare

A great place to work.

Are you ready for new challenges and new opportunities?

Current job opportunities are posted here as they become available.

Reimbursement Specialist (Home Health exp. Preferred)

Position Summary: The Reimbursement Specialist (Home Health) will be responsible for billing and revenue cycle management thorough insurance benefit investigation of new referrals, assignment of collections with a variety of payers, authorization requests, and claim submissions. We would like to hire someone familiar with Home Health especially EVV as well as Private Duty experience.

Schedule: Monday-Friday 8am to 5pm Central Standard Time (Remote)

>> We offer our team the best <<

• Medical, Dental and Vision Benefits
• PTO Plan
• Retirement Planning
• Life Insurance
• Accurately interprets patient insurance, prescription and other health-related documentation
• Conducts medical insurance verifications and investigations for commercial and government payors
• Communicates with insurance companies, patients, providers and prescribers to coordinate reimbursement and access solution
• Reviews unpaid accounts to determine status and taking appropriate action to ensure payment.
• Reviews all claims for compliance and completeness for claims submissions.
• Researches available alternative funding options to reduce patient’s financial burden
• Handles high call volumes
• Communicates with internal and external departments to facilitate coordination of care
• Maintains a high degree of confidentiality at all times due to access to sensitive information
• Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
• Follows all Medicare, Medicaid, and HIPAA regulations and requirements
• Abides by all regulations, policies, procedures and standards
• Performs other duties as assigned
• High school diploma or equivalent is required; Undergraduate degree is preferred
• 5 years of healthcare collections/billing experience preferred
• Strong understanding of hospice billing regulations (Medicare, Medicaid, commercial
• Ability to read and interpret EOBs, remittances, and denial codes
• Effective payer follow-up and escalation strategies
• Ability to resolve claim holds, rejections, and denial
• Ability to identify trends in denials or delay
• Root-cause analysis to prevent recurring issues
• High attention to detail to ensure clean claims
• Ability to work AR reports and aging summaries accurately
• Clear, professional communication with internal teams and payer reps
• Ability to explain payer issues in plain, understandable language
• Possess quick and accurate Alpha/numeric data entry skills
• Computer proficiency – MS Office and Web-enabled applications strongly preferred
• Maintains positive internal and external customer service relationships
• Plans and organizes work effectively and ensures its completion
• Meets all productivity requirements
• Demonstrates team behavior and promotes a team-oriented environment
• Actively participates in Continuous Quality Improvement
• Represents the organization professionally at all times
• Self-starter with exceptional organizational and follow-through skills
• Ability to work independently and in a team environment