What are the responsibilities and job description for the Claims Support Specialist position at Integrated Home Brand?
Who we are:
IHCS provides an Integrated Delivery System in the home setting, which includes, DME, Respiratory, Home Health and Home Infusion services. IHCS has a select network of Medicare and/or Medicaid Certified and Accredited providers to respond to the needs of our patients – 24/7. We operate with the sole intent of providing the highest quality in-home care services that improve and enhance the daily living for our patients, where our patients are #1
With over 15 years of experience, we are the trusted market leader in Home Health, Durable Medical Equipment, and Home Infusion Services. If you are passionate about inspiring, motivating, and leading teams this opportunity could be for you and we want to hear from you!
Join our team as we strive for excellence through teamwork. We are committed to delivering high quality care to our patients through Exceptional Customer Service, Proven Outcomes, and Seamless Care.
Full time team members competitive compensation package, include but not limited to;
- Medical, Vision, Dental, Short- and Long-term insurance
- 6 Days of Holidays Pay
- 16 days of PTO
- Employer paid life insurance
- 401K with employer contribution
- Wellness program with reward incentives
- Employee recognition and reward programs
- Comprehensive paid training program
What will you be doing:
The Claims Support Specialist is responsible for reviewing and updating referral authorizations to ensure accurate claims adjudication for home health services and durable medical equipment (DME). This role involves working within Medtrac and possibly HRP systems to process authorization corrections, resolve discrepancies, and maintain compliance with payer policies, regulatory requirements, and contractual agreements for all lines of service, HH, DME and infusion. This role requires full knowledge of the end-to-end referral. The specialist will collaborate with the care coordination team, claims processing, and provider relations teams to ensure timely approvals and accurate claims processing. Additionally, this role requires strong knowledge of referral processing workflows, adherence to compliance standards, and the ability to identify and escalate issues affecting claims accuracy.
What will you come with:
- High school diploma or equivalent
- Experience in referral authorization processing, claims adjudication, or medical billing for home health and DME is strongly preferred.
- Strong knowledge of healthcare insurance, prior authorizations, medical necessity guidelines, and payer policies.
- Familiarity with medical terminology, CPT, HCPCS, ICD-10 codes, and home health/DME billing practices.
- Excellent analytical, problem-solving, and communication skills.
- Ability to work independently and collaboratively in a fast-paced environment.
Certifications and additional qualifications:
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- Associate’s or Bachelor’s degree in healthcare, business, or a related field preferred).
- Experience with Microsoft Excel and database experience preferred.
- Ability to manage and handle multiple products and services while meeting established service requirements.
Join our team as we strive for excellence through teamwork, where our patients are #1!
IHCS is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
