Revenue Cycle Specialist

Heart to Heart Hospice•Plano, TX

6d•Onsite

About The Position

This role is responsible for accurately entering patient/client billing data, including nursing home rates, level of care, per diem, physician billing, visit charges, and fee for service charges. The specialist will also verify discharge and admission data. A key part of the role involves coordinating, reviewing, and analyzing documentation and data entry to support Medicare, Medicaid, and commercial payer requirements, ensuring accurate and timely billing. The position requires confirming and ensuring the accuracy of data within the EMR and maintaining tracking tools to secure all necessary information for timely and accurate payment. This includes managing eligibility, insurance verification, authorizations, certification and recertification, state-required documentation for Medicaid, and Room and Board payments. The role also involves the timely submission of all documentation, conducting business activities professionally and ethically, performing other duties as required, and ensuring overall compliance with local, state, and federal laws, Medicare regulations, and established personnel policies and procedures.

Requirements

High school diploma or its equivalent required
Texas & Michigan Medicaid experience
Must be knowledgeable of reimbursement processes and procedures.
Proficient in Microsoft Outlook, Word, Excel, PowerPoint and computer literacy
Organized work habits, accuracy, and proven attention to detail, with strong analytical skills

Nice To Haves

Associate degree preferred
Multi-state experience, preferred
Hospice billing experience.
Experience with HomeCare Homebase preferred

Responsibilities

Accurately enter patient/client billing data, nursing home rates, level of care, per diem, and physician billing or charges, visit charges, fee for service charges, and verify discharge and admission data.
Coordinate, review, and analyze documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing.
Confirm and ensure accuracy of the data in EMR.
Maintain tracking tools to ensure that all necessary information is secured for timely accurate payment. This includes eligibility, insurance verification, authorizations, certification and recertification, state required documentations for Medicaid and Room and Board payment.
Timely submission of all documentation.
Conduct all business activities in a professional and ethical manner.
Performance of other duties as required.
Ensure overall compliance with local, state and federal laws, Medicare regulations, and established personnel policies and procedures.