Reimbursement Specialist (Skilled Hospice)

Addus HomeCare•Frisco, TX

1d•Remote

About The Position

The Reimbursement Specialist (Skilled Reimbursement/Hospice) will be responsible for billing and revenue cycle management thorough insurance benefit investigation of new referrals, assignment of collections with a variety of payers, authorization requests, and claim submissions. Schedule : Monday-Friday 8am to 5pm Central Standard Time (Remote) >> We offer our team the best << Medical, Dental and Vision Benefits Continued Education PTO Plan Retirement Planning Life Insurance Employee discounts

Requirements

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/numeric data entry skills
Computer proficiency MS Office and Web-enabled applications strongly preferred
Customer service skills required.
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

Nice To Haves

Undergraduate degree is preferred
5 years of healthcare collections/billing experience preferred
Computer proficiency MS Office and Web-enabled applications strongly preferred

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 patients 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