Home Health Billing Analyst I

Graham Healthcare Group

2d•Remote

About The Position

SUMMARY Support Billing Management to ensure timely and correct claims are filed with all respective payers and intermediaries. Monitor claims for timely processing of payments and rejections and work A/R on a weekly basis. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned as necessary. • Perform claim audit review for Medicare and PDGM Medicare Commercial • Work the Medicare/Medicare PDGM Claims Held workflow • Maintain responsibility for Oasis reports • Review unbilled reports for Medicare and Non-Medicare on a weekly basis • Bill Medicare/Non-Medicare claims on a daily basis • Review pre-post report to verify all visits have a usual and customary rate and contractual adjustment on a bi-weekly basis • Work Medicare/Non-Medicare claim rejections • Perform billing note entry on all outstanding accounts over 30 days • Make insurance calls to check status on outstanding claims • Process requests for additional information from Insurance Companies • Answer billing queue calls • Collect patient payments via the phone • Work monthly Medicare, Medicare, HMO, and 3rd-party agencies • Review Monthly SOX report to ensure every account over 30 days has a Billing note • Cover department when other employees are ill or on vacation • Duties may vary depending on which insurance team the employee is on • Comply with Company’s Core Values and Core Competencies • Perform other duties as assigned by supervisor

Requirements

High school education or equivalent
Minimum of one to three years billing experience (preferred in home health care)
Proficiency in Microsoft Office Suite
Knowledge of Esolutions, Waystar, and commercial web portals
Understanding of Medicare FSSO DDE software
Strong computer knowledge
Demonstrated patience, flexibility, and cooperative attitude
Strong communication skills with other office staff
Conscientiousness and attention to detail

Responsibilities

Perform claim audit review for Medicare and PDGM Medicare Commercial
Work the Medicare/Medicare PDGM Claims Held workflow
Maintain responsibility for Oasis reports
Review unbilled reports for Medicare and Non-Medicare on a weekly basis
Bill Medicare/Non-Medicare claims on a daily basis
Review pre-post report to verify all visits have a usual and customary rate and contractual adjustment on a bi-weekly basis
Work Medicare/Non-Medicare claim rejections
Perform billing note entry on all outstanding accounts over 30 days
Make insurance calls to check status on outstanding claims
Process requests for additional information from Insurance Companies
Answer billing queue calls
Collect patient payments via the phone
Work monthly Medicare, Medicare, HMO, and 3rd-party agencies
Review Monthly SOX report to ensure every account over 30 days has a Billing note
Cover department when other employees are ill or on vacation
Comply with Company’s Core Values and Core Competencies
Perform other duties as assigned by supervisor