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Reimbursement Specialist (Home Health & Hospice Collections Exp) Addus Homecare - 3.4 Frisco, TX Job Details 20 hours ago Benefits Health insurance Dental insurance Paid time off Vision insurance Employee discount Life insurance Qualifications Customer communication Customer relationship building Defect resolution root cause analysis Medicare Accounts receivable management Hospice experience Regulatory compliance in claims processing High school diploma or GED Internal employee customer service Medicare regulations Centers for Medicare and Medicaid Services (CMS) Medical denial root cause analysis (RCA) Insurance investigations Centers for Medicare & Medicaid Services (CMS) billing regulations Medical explanation of benefits reviews Medicaid regulations Medicaid Continuous quality improvement (CQI) Root cause analysis Medical debt collection accounts Medical claim status updates Quality data entry Patient collections management

Full Job Description Position Summary :

The Reimbursement Specialist (Home Health/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. We would like to hire someone with Home Health or Hospice Collections Experience.

Schedule :

Monday-Friday 8am to 4:40 or 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

Essential Duties:

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 patient's 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

Position Requirements & Competencies:

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 To apply via text, text 11784 to 334-518-4376 #ACADCOR #

CBACADCOR

#DJADCOR #IndeedADCOR Employee wellbeing is top priority at Addus Homecare, and we're thrilled to announce our recognition as the top healthcare company on Indeed's 2024 Top 100 Work Wellbeing Index.

View the full rankings here:

https://www.indeed.com/employers/work-wellbeing/work-wellbeing-100-ranking.