Pre Billing Lead / Mansfield Certified Admin

Hartford Healthcare•Mansfield, CT

About The Position

Hartford HealthCare at Home is seeking a Pre-Billing Lead to oversee its pre-billing audit process and help keep the revenue cycle accurate, compliant, and timely. The lead serves as a subject matter expert for the team, coordinating workflows, supporting quality assurance and compliance, and training and mentoring pre-billing staff. The role includes reviewing patient charts in HCHB to verify that clinical documentation and billing data are complete and compliant before claims are submitted, and working with clinical staff to address discrepancies or missing information. The position also supports denial prevention, quality improvement, process standardization, and communication between pre-billing staff and leadership. Hartford HealthCare describes this role as part of a career advancement pathway for experienced auditors and offers a competitive benefits program.

Requirements

High school diploma.
At least 2 years of experience in home health billing, auditing, or clinical documentation review.
Advanced knowledge of home health billing regulations, payer requirements, and auditing techniques.
Excellent attention to detail and strong organizational skills.
Strong written and verbal communication skills.
Ability to work with autonomy, assertiveness, flexibility, and cooperation.
Appropriate certification may be required.

Nice To Haves

Bachelor’s degree.
3 or more years of experience in home health billing, auditing, or clinical documentation review.

Responsibilities

Oversee pre-billing audits to ensure clinical documentation and billing data are reviewed accurately and on time before claims are submitted.
Serve as the lead subject matter expert for problem solving, workflow coordination, quality assurance, and compliance with regulations, guidelines, and policies.
Train, mentor, and support pre-billing staff during onboarding and ongoing development, promoting audit quality and consistency.
Review patient charts in HCHB to confirm required documentation is complete and compliant before billing, including validating visit frequencies, orders, and care plans against billing requirements.
Confirm that all disciplines have signed and locked notes and that visits are properly scheduled and documented.
Identify and resolve discrepancies or missing documentation that could delay billing by partnering with clinical staff to obtain corrections or additional information.
Stay current on Medicare, Medicaid, and commercial payer guidelines and regulatory changes, and help train staff on documentation and billing compliance best practices.
Monitor workflow performance, identify process improvement opportunities, and support denial prevention, quality improvement, and process standardization efforts.
Strengthen communication between pre-billing staff and leadership.