Reimbursement Specialist (Home Health & Hospice Exp)

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Reimbursement Specialist (Home Health & Hospice Exp)
Position Summary
The Reimbursement Specialist (Home Health/Hospice) will be responsible for billing and revenue cycle management through 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 experience and having HCHB experience is a plus.

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

Pay
$21 to $24 hourly

Benefits

Medical, Dental and Vision Benefits

PTO Plan

Retirement Planning

Life Insurance

Responsibilities

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

Qualifications

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
umeric 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

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