Home Health Billing Specialist

About Us:
At Your Tailor Made Senior Service, we deeply value diversity, equity, and inclusion. These principles are the foundation of our culture, and we are steadfast in our commitment to fostering an environment that respects and celebrates our differences, while valuing the contributions of all.

Job Summary:
We are seeking a Home Health Billing Specialist, an individual who will be responsible for managing account payments from Triwest, Medicare, Medicaid, and private insurance. This role includes tasks such as submitting claims, liaising with insurance companies, and ensuring our practices remain compliant with Home Health and hospice regulations.

Who We Are Looking For:
A friendly, organized, and focused individual adept at using Excel and comfortable with both making and answering phone calls.

Key Responsibilities:

• Insurance Verification: Ensure patients' insurance coverage and benefits are clarified.
• Pre-Authorization: Obtain necessary approvals from insurance companies.
• Communication: Act as the bridge between the office, insurance companies, and patients.
• Documentation: Maintain accurate records of authorizations, denials, and pertinent communication.
• Appeals: Assist in the process of appealing denied authorizations.
• Compliance: Abide by relevant laws and regulations, including HIPAA.
• Patient Education: Help patients understand their insurance coverage and associated costs.
• Problem-Solving: Address complex cases ensuring patients receive the care they need.

Skills Required:

• Exceptional Communication Skills
• Proficiency in Microsoft Excel & Word
• Reading and Writing Proficiency
• Prior experience with Home Healthcare Software is an advantage.

Essential Functions:

• Submit claims to Medicare and Medicaid.
• Gather necessary data to prepare insurance claims.
• Address provider inquiries.
• Ensure accurate and compliant billing practices.
• Resolve billing issues and delinquencies.
• Interpret Explanation of Benefits.
• Attend to other related duties and tasks.

Administrative Functions:

• Handle, document, and distribute hard copy checks.
• Manage requests for billing records from patients or third parties.
• Oversee receipt and filing of revenue cycle department correspondence.
• Field incoming calls, voicemails, and emails; directing them appropriately.

Qualifications:

• Minimum 2 years of healthcare billing experience.
• High school degree or equivalent.
• Proficiency in Microsoft Office, especially Excel.
• Strong multitasking, organizational, and prioritization skills.
• Excellent interpersonal and communication skills.
• Prior experience with Home Health and hospice billing is a plus.
• Familiarity with relevant billing software is preferred.

Physical Demands:
This role involves both desk-based tasks and light physical activities. The employee is expected to communicate effectively in various formats and might be exposed to minor workplace hazards. Reasonable accommodations are available for individuals with disabilities.

Continuing Education:
We encourage our staff to continue learning. Attending in-service programs and other educational opportunities is essential for maintaining professional certifications and enhancing your skills.

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