Highlights
This individual will be responsible for managing the full billing and reimbursement cycle, ensuring accurate claim submission, timely collections, denial resolution, and compliance with Medicare, Texas Medicaid, and commercial insurance requirements. Collaborate with clinical and administrative teams to resolve documentation discrepancies and ensure services are appropriately supported for billing.
Numbers & Facts
| Location | San Antonio, TX |
| Industry | Staffing/Employment Agencies |
| Company Size | 100 to 499 employees |
| Website | https://www.prg-usa.com/ |
Description
Our client is seeking an experienced Billing Manager to oversee medical billing operations for a home health organization. This individual will be responsible for managing the full billing and reimbursement cycle, ensuring accurate claim submission, timely collections, denial resolution, and compliance with Medicare, Texas Medicaid, and commercial insurance requirements.
Key Responsibilities
- Manage daily medical billing operations for home health services, including preparing, reviewing, and submitting electronic and paper claims.
- Oversee billing and reimbursement processes for Medicare, Texas Medicaid, and commercial insurance providers.
- Verify patient insurance eligibility and coverage to ensure accurate billing and appropriate reimbursement.
- Monitor claim submissions and proactively identify and resolve rejected, denied, delayed, or underpaid claims.
- Manage accounts receivable follow-up, collections, and outstanding balances to support timely reimbursement and reduce aging receivables.
- Review billing documentation for accuracy, completeness, and compliance with payer requirements.
- Collaborate with clinical and administrative teams to resolve documentation discrepancies and ensure services are appropriately supported for billing.
- Maintain accurate billing records, payment documentation, and supporting information for audits and reporting.
Required Qualifications
- Minimum of 35 years of medical billing experience, preferably within a home health organization.
- Strong knowledge of Medicare, Texas Medicaid, and commercial insurance billing requirements.
- Experience with claim submission, denial management, payment posting, accounts receivable, and collections.
- Working knowledge of ICD-10, CPT, and HCPCS coding.
- Familiarity with OASIS, Electronic Visit Verification (EVV), and home health billing workflows.
- Proficiency with medical billing software and electronic medical record systems.
Benefits
- Competitive salary based on experience.
- Health, dental, vision, and supplemental insurance options.
- Paid time off and company holidays.
- 401(k) with company match.
- Opportunities for professional growth and development.
About Company
Established in 2001, Peyton Resource Group is a solution-based staffing company that matches businesses with top talent for short-term, long-term or permanent needs.
People are a business’s most valuable asset. Peyton Resource Group is dedicated to helping companies find the best talent, matching professionals with jobs where they will thrive.
With locations in Dallas/Fort Worth, San Antonio and Austin, we are available to serve your staffing needs throughout Texas and across the country.