HOME HEALTH BILLING & REIMBURSEMENT SPECIALIST

Beebe Healthcare•Millsboro, DE

12h•Onsite

About The Position

Responsible for all aspects of billing and reimbursement with emphasis on Medicare PPS and compliance, and cash posting, accounting. Responds to billing inquiries and denials.

Requirements

Minimum of three (3) years of experience with third-party reimbursement in a healthcare patient accounting, billing, or revenue cycle environment.
Minimum of three (3) years of experience in healthcare billing, reimbursement, accounts receivable, or denial management.
Home Health billing and reimbursement experience required.
Experience working with Medicare PPS reimbursement methodologies and compliance requirements.
Strong knowledge of third-party payer reimbursement processes, including Medicare, Medicaid, and commercial insurance plans.
Thorough understanding of UB-92/UB-04 billing requirements and claim submission processes.
Knowledge of ICD-9, ICD-10, CPT, and HCPCS coding principles.
Experience with denial management, appeals, and reimbursement recovery.
Proficiency in Microsoft Office applications, including Excel, Word, and PowerPoint.
Demonstrated experience working in information technology environments and healthcare database management systems.
Strong financial analysis and accounts receivable management skills.
Ability to develop, analyze, and prepare reports related to reimbursement and revenue cycle performance.
Exceptional attention to detail and accuracy.
Excellent verbal, written, and interpersonal communication skills.
Ability to manage multiple priorities, meet deadlines, and work independently.
Strong problem-solving and critical-thinking abilities.

Nice To Haves

Certified Billing and Coding Specialist (CBCS) preferred.
Additional revenue cycle, coding, or reimbursement certifications are a plus.

Responsibilities

Manage home health billing and reimbursement activities, ensuring compliance with Medicare PPS and third-party payer requirements.
Verify insurance coverage and maintain accurate patient billing information within the Home Health EMR.
Submit, monitor, and follow up on claims to ensure timely and accurate reimbursement.
Investigate and resolve claim denials, payment discrepancies, and billing inquiries.
Post payments, adjustments, and accounts receivable transactions accurately.
Maintain complete documentation and update records within the Home Health EMR system.
Communicate billing issues, reimbursement delays, and payer changes to the Reimbursement Analyst.
Generate billing and accounts receivable reports and assist with revenue cycle improvement efforts.
Collaborate with Home Health team members and other departments to support efficient reimbursement processes.
Maintain current knowledge of reimbursement regulations, coding requirements, and payer guidelines.
Perform other duties as assigned.