Billing Professional - Medicare

Pinnacle Career • Oldsmar, FL

1d

About The Position

Are you looking to make a difference in patients’ lives with a company that values your expertise? Join us in our mission of delivering compassionate healthcare where it matters most –– at home. Pinnacle Home Care, Florida’s largest independent Medicare-certified home health provider, has been delivering high-quality, patient-centered care for over two decades, and we’re looking for a Reimbursement Analyst to join our award-winning team. Key Responsibilities Daily collection activities for designated accounts, leading to the timely reimbursement of receivables using available resources including external/internal databases, payer portals/websites, and telephone. Daily review of EOPs/EOB/Ras/EOMBs for accuracy and patient responsibility. Take appropriate action to resolve denied/rejected invoices and preparation of payer corrections and/or appeals in accordance with payer plan requirements using electronic and paper processes. Ensures that all reconciled items and past due balances are resolved to completion through contact and follow-up with Payers/Patients. Calculate expected reimbursement percentages based on contracted rates and properly notate accounts. Utilize appropriate systems to actively contact Payers/Patients for account transactions. Responds to all inquiries with a resolution to concerns and/or discrepancies. Identify trends, opportunities, and report data to direct supervisor same day. Meet productivity goals assigned by the Billing/Reimbursement Manager. Communicates professionally with inter-company departments on resolution of potential disputed items. Participates in payer webinars and conference calls covering a wide range of topics that enables the Billing Team to effectively bill and collect accounts receivable. Assists in the training of all new A/R personnel when needed. Complies with HIPAA regulations on all accounts. Protects the confidentiality of patient and organization information through effective controls and direct supervision of operations. Additional Duties/Tasks may apply as the business needs of the company evolve.

Requirements

• High school diploma or equivalent; minimum of 2 years’ experience in revenue cycle collections.
• Strong knowledge of managed care, commercial insurance, and insurance portals.
• Proficient in interpreting insurance remittances and episodic billing methodologies (e.g., PPS, PDGM).
• Proficient in Microsoft Office and general computer applications.
• Ability to prepare and analyze reports and business correspondence.
• Excellent organizational and time management skills with the ability to meet tight deadlines.

Responsibilities

• Daily collection activities for designated accounts, leading to the timely reimbursement of receivables using available resources including external/internal databases, payer portals/websites, and telephone.
• Daily review of EOPs/EOB/Ras/EOMBs for accuracy and patient responsibility.
• Take appropriate action to resolve denied/rejected invoices and preparation of payer corrections and/or appeals in accordance with payer plan requirements using electronic and paper processes.
• Ensures that all reconciled items and past due balances are resolved to completion through contact and follow-up with Payers/Patients.
• Calculate expected reimbursement percentages based on contracted rates and properly notate accounts.
• Utilize appropriate systems to actively contact Payers/Patients for account transactions.
• Responds to all inquiries with a resolution to concerns and/or discrepancies.
• Identify trends, opportunities, and report data to direct supervisor same day.
• Meet productivity goals assigned by the Billing/Reimbursement Manager.
• Communicates professionally with inter-company departments on resolution of potential disputed items.
• Participates in payer webinars and conference calls covering a wide range of topics that enables the Billing Team to effectively bill and collect accounts receivable.
• Assists in the training of all new A/R personnel when needed.
• Complies with HIPAA regulations on all accounts.
• Protects the confidentiality of patient and organization information through effective controls and direct supervision of operations.
• Additional Duties/Tasks may apply as the business needs of the company evolve.

Benefits

• Growth & Stability: Over two decades as Florida’s largest independent home health agency.
• Competitive Benefits & Perks: Including an employee referral program where you can earn rewards.
• Recognized Excellence: Ranked as a USA Today Top Workplace.
• Supportive & Fun Culture: Join a collaborative, forward-thinking team that values both professional excellence and personal fulfillment.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees