Home Health Billing and Eligibility Specialist

Home Health Office seeking medical billing, coding and eligibility specialist. Hybrid position will be considered. Part-time initially - will be increasing to full-time with benefits. Applications to be accepted and considered until June 1, 2025. Position will begin between June and July, 2025. 

General Purpose:

Facilitates prompt and accurate billing, determines patient and client insurance eligibility and coverage,  monitors the client receivable status, and initiates collection protocols to prevent past due invoices.  

Essential Functions:

• Performs branch payroll activities including, but not limited to, transferring/inputting client orders to the system, organizing and inputting time slips, verifying visit for each client, calculating pay, making appropriate deductions, auditing input and ensuring readiness for payroll processing.
• Complies with all federal, state and local laws and regulations regarding the payroll function by using the appropriate accounting standards.
• Provides management with needed billing reports.
• Generates billing information from the system and sends to appropriate party.
• Maintains billing system, including entering and assuring accuracy of all billing information.
• Tracks all invoices with special payment terms, including credit card and bank drafts.
• Responds to inquiries from clients, payer and offices in a timely manner. Takes appropriate steps to resolve areas of concern within limits of authority.
• Documents all client calls in the billing system.
• Provides weekly reports for management.
• Analyzes accounts receivable file to determine potential receivable problems.
• Contacts clients and payer sources to facilitate debt collection.
• Serves as liaison between billing and monitoring centers to ensure prompt and accurate invoicing.
• Monitors the aging report and send appropriate alerts to enter for delinquent accounts.
• Recommends strategies to improve collection on past due accounts.
• Determines eligibility for services based on insurance coverage.
• Reviews account receivable file to determine potential bad debts and notify manager with recommended write-offs.
• Prioritizes workload to complete tasks within required timeframe.
• Completes other assignments as requested and assigned.
• May have access to personal health information (“PHI”) necessary to fulfill the above duties and responsibilities.  Access to use and ability to disclose PHI is further defined by each organization/department.

Minimum Education & Experience Requirements:

• Associate Degree in Accounting or equivalent years experience and training OR

•       Certificate in medical coding/billing

• Two (2) years collections and billing experience, preferably in the home health industry.

Knowledge, Skills & Abilities Required: 

• Strong background of problem solving regarding billing and payables issues.

• Detail oriented with strong organization, analytical and problem-solving skills.

• Advanced communication and interpersonal skills.

• Proficient with Microsoft Word, Excel and PowerPoint software.

• Ability to read and interpret financial reports.

• Demonstrated ability to work under pressure with multiple tasks, changing priorities, short deadlines and heavy workload.

• Working Conditions & Physical Effort: 
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• Work is normally performed in a typical interior/office work environment.
• Ability to work flexible schedule and/or evening hours as needed.
• Ability to sit in front of CPU for long periods of time.
•  
• Physical activity is sedentary and may require occasional lifting or carrying up to 10 lbs.