Position Summary: The Reimbursement Specialist (Home Health/Hospice) 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 with Home Health or Hospice Collections Experience.
Schedule: Monday-Friday 8am to 4:40 or 5pm Central Standard Time (Remote)
>> We offer our team the best <<
- Medical, Dental and Vision Benefits
- Continued Education
- PTO Plan
- Retirement Planning
- Life Insurance
- Employee discounts
Essential Duties:
- 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
Position Requirements & Competencies:
- 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
- Customer service skills required.
- 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
To apply via text, text 11784 to 334-518-4376
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