Revenue Cycle Specialist

Job Summary:

American River Health Care, a trusted and locally owned agency, is seeking a highly skilled and experienced Home Care Medicare Biller/Collector to join our team. As a key member of our revenue cycle department, you will manage the billing and collections processes for our home care division, ensuring timely, accurate, and compliant submissions to Medicare and Medicare HMO / PPO insurers. Your work will directly impact the financial health of our organization and contribute to the restoration of our patients' well-being.

Responsibilities:

• Oversee the end-to-end process of home care billing and Medicare/Medicare HMO/PPO claims for home health services, ensuring accuracy and compliance with regulatory requirements.
• Review and prepare patient bills, invoices, and statements, ensuring correct coding and appropriate payer requirements.
• Serve as the primary point of contact for insurance companies, patients, and healthcare providers to resolve billing discrepancies, disputes, and payment issues.
• Follow up on unpaid or denied claims, ensuring timely resolution and maximizing reimbursement.
• Stay current with changes in Medicare regulations, payer guidelines, and industry best practices for revenue cycle management.
• Work closely with internal staff and clinicians to ensure that all documentation supports billing requirements and reimbursement standards.
• Identify opportunities for process improvements and contribute to the development of strategies aimed at enhancing operational efficiency and financial outcomes.

Qualifications:

• Minimum of 2 years of experience in home care billing and collections, with a focus on Medicare, Medicaid, and commercial insurance.
• Proficient knowledge of home infusion billing processes and related Medicare/PBM billing regulations (experience in this area is a plus).
• Deep understanding of healthcare billing regulations, compliance guidelines, and payer-specific requirements.
• Proven ability to analyze denials and effectively navigate the appeals process to secure reimbursement.
• Strong attention to detail, analytical skills, and ability to prioritize tasks efficiently.
• Excellent communication and interpersonal skills for effective collaboration with both internal teams and external stakeholders.
• Proficiency with billing software and electronic health record (EHR) systems, with experience in Medicare billing software a plus.

Compensation and Benefits:

• This is a full-time position. Monday to Friday 8:30am-5:00pm
• Hourly compensation: $23.00 - $27.00 per hour, based on experience.
• Comprehensive benefits package, including health insurance, dental and vision coverage, life insurance, 401(k) with matching, and paid time off.

At American River Health Care, we are committed to providing compassionate care while ensuring the financial stability of our services. If you have a passion for home care billing and collections and want to be part of a dedicated team, we encourage you to submit your resume and join us in our mission to improve the lives of our patients.

Salary : $23 - $27