Demo

Billing Specialist

Stonerise at Home
Indianapolis, IN Full Time
POSTED ON 4/17/2025
AVAILABLE BEFORE 5/14/2025

Home Health and Hospice Biller

Since 1984,  CommuniCare Family of Companies  has been committed to delivering exceptional person-centered care as a national leader in post-acute care for those that are chronically ill or have complex conditions.

Our more than 150 skilled nursing, assisted living, independent living, behavioral health and long-term care facilities deliver sophisticated and transformative care to nearly 16,000 residents and patients at any given time. CommuniCare employs more than 19,000 employees across seven states (Ohio, Indiana, Maryland, Virginia, West Virginia, Pennsylvania, and Missouri).

CommuniCare’s Home Health and Hospice Division Services  is currently recruiting a  Home Health and Hospice Biller for our Central Intake department located in Blue Ash, Ohio . This position will be hybrid with an expectation to commute to our office in Blue Ash as needed.

PURPOSE / BELIEF STATEMENT

The position of Home Health and Hospice Biller is responsible for billing, receivables auditing, and collections activities for services provided to patients at the Home Health and Hospice agency level. Ultimately, this position is responsible for ensuring the financial health of our home health and hospice agencies. This employee will be responsible for accurately billing Medicare, Medicaid, private pay, and other insurance for home health and hospice services provided to patients. Attention to detail, understanding of Medicare and Medicaid regulations, and ability to navigate complex billing systems will be critical in this role.

Qualifications

  • High school diploma or equivalent required; an associate or bachelor's degree in healthcare administration, finance, or a related field is preferred.
  • Prior experience in healthcare billing, with a focus on Home Health Medicare billing, is highly desirable.
  • Proficiency in using billing software and electronic medical record (EMR) systems.
  • Comprehensive knowledge of Medicare regulations and guidelines related to home health and hospice billing.
  • Exceptional attention to detail and accuracy in data entry and recordkeeping.
  • Strong written and verbal communication skills.
  • Ability to work independently and collaboratively in a dynamic and fast-paced environment.
  • Excellent organizational and time management skills.
  • Familiarity with HIPAA regulations and patient privacy requirements.

JOB DUTIES & RESPONSIBILITIES

  • Prepare and submit claims for home health and hospice service claims in compliance with Medicare and Medicaid regulations for West Virginia, Ohio, and Indiana.
  • Accurately process and bill claims for Medicare, Medicaid, private payers, other insurance providers, and patients according to payer requirements and organizational policies.
  • Review patient records to ensure proper coding and documentation support for billed services.
  • Monitor claims for accuracy and completeness, promptly addressing discrepancies or issues.
  • Follow up on unpaid or denied claims, resubmitting and appealing as necessary.
  • Stay updated on changes to Medicare, Medicaid, and other insurance billing regulations and requirements.
  • Meet monthly resolution goals while minimizing the impact of bad debt for assigned agencies.
  • WHAT WE OFFER

    As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer you a menu of benefit options from life and disability plans to medical, dental and vision coverage, from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts. Qualified candidates, forward your resume for a chance to join the World Class team at CommuniCare!

    QUALIFICATIONS / EXPERIENCE REQUIREMENTS

  • Knowledge of Medicare & Secondary Billing Guidelines
  • Medicare experience preferred.
  • SNF experience preferred.
  • Previous experience billing various Medicare and Co-insurance companies and understanding the requirements for each payor
  • Claims appeal / resolution expertise preferred
  • 2 - 4 years advanced education beyond high school, or comparable work experience
  • Strong verbal and written skills are required in order to interact with insurance companies to resolve unpaid claims via telephone and written correspondence
  • Professional appearance and mannerisms
  • Ability to work as part of a team
  • Computer skills including, but not limited to Microsoft Word, Excel, and Outlook
  • Knowledge of Point Click Care, Quadax and Availity preferred
  • JOB DUTIES & RESPONSIBILITIES

  • As Medicare payment occurs, identify and submit billing for secondary claims that do not automatically crossover to secondary insurance
  • Daily cash posting per Cash Postings policy
  • Follow-up on unpaid claims and document account within standard billing cycle time frame  (Medicare : 16 days after submission , Commercial / Medicaid Coinsurance : 14-21 days after submission)
  • Identify and submit necessary rebilling for secondary / tertiary claims during follow-up
  • Conduct account research and analysis
  • Submission of write offs for uncollectable accounts
  • Interact with facility staff to resolve outstanding issues
  • Participate in monthly A / R reviews
  • Participate in the month end close process.
  • Other various duties as assigned
  • About Us

    A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients, and family members care for and about one another.

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