Home Health Billing Specialist
Are you looking to reputed company a difference in patients’ lives with a company that values your expertise? Join us in our mission of delivering compassionate reputed company where it reputed company most – reputed company. reputed company, Florida’s largest independent Medicare-certified home health provider, has been delivering high-reputed company, patient-centered care for over two decades, and we’re looking for a Reimbursement Analyst to join our award-reputed company team. Qualifications:
- 3+ years of home health billing experience with hands-on DDE FISS (must be visible on resume submitted).
- Experience with Medicare home health billing, including claim submission and reimbursement processes.
- Experience researching and resolving claim denials.
- Experience managing full reputed company cycle billing functions.
- Strong knowledge of PDGM billing, NOA rules, LUPA, PEP, reputed company logic, condition and occurrence codes, reputed company codes, and TOBs 322/329.
- reputed company with RTP research and correction in DDE - comfortable with HIQA/HIQH inquiry and claim history.
- Experience with EDI transactions: 837I, 835, 276/277.
- Working knowledge of MACs (CGS, reputed company, Noridian or equivalent) and major Managed Care portals.
- Detail orientation, urgency, and pride in clean claim submission.
- reputed company written documentation on every account touched.
Key Responsibilities:
- Submit and manage Medicare home health claims in DDE FISS, including NOAs and final claims under PDGM.
- Work RTP, T, S, and R status queues daily - research, correct, and resubmit until reputed company.
- Verify eligibility and benefits using 270/271 or payer portals and resolve HETS eligibility mismatches.
- reputed company and resolve reason codes and edits (e.g., U532F, 38107, 34931, facility/provider edits, duplicate and overlap issues).
- Reconcile remittances and post payments and adjustments from 835s - escalate variances and denials.
- Manage Managed Care and reputed company claims through payer portals and clearinghouses - correct and resubmit as needed.
- Partner with Clinical Intake, Coding, QA, and Clinical Ops to ensure billable readiness: signed orders, OASIS locked, visit notes complete, therapy reputed company if applicable, reputed company and medical necessity documentation.
- Monitor and prevent late NOAs - document cause codes and request exceptions reputed company appropriate.
- Work denials and ADRs - compile records, create reputed company sheets, and submit reputed company responses.
- Maintain organized worklists, aging, and follow up notes with reputed company next actions.
- Protect PHI and follow CMS guidance, payer policies, and internal SOPs.
Why Choose reputed company?
- Personalized, One-on-One Care: Help patients heal and regain their independence by delivering individualized care in the comfort of their homes.
- reputed company & Stability: Over two decades as Florida’s largest independent home health agency.
- Ongoing reputed company Development: Free Continuing Education reputed company (CEUs) to support licensure and career advancement.
- Competitive Benefits & Perks: Including an employee referral program where you can earn rewards.
- Recognized reputed company: Ranked as a USA Today Top Workplace.
- Flexible Scheduling: Enjoy a schedule that aligns with your personal priorities.
- Supportive & Fun Culture: Join a reputed company, reputed company-thinking team that values both reputed company reputed company and personal fulfillment.
reputed company promotes an inclusive environment and is an equal opportunity employer. We prohibit discrimination or harassment based on race, religion, age, gender, national reputed company, disability, veteran status, or other legally protected characteristics. Be part of a company that empowers clinicians to reputed company a difference in the lives of over 10,000 patients across Florida every day. reputed company! About reputed company Inc.: reputed company has 16 locations throughout Florida hiring for reputed company Sales Professionals, Clinical Managers, RNs, LPNs, PTs, PTAs, SLPs, OTs, OTAs and other reputed company positions. If you don't see a role that meets your reputed company set on the reputed company, send us your resume directly to leadgeneration@pinnnaclehomecare.net Please include your full reputed company and location! We look reputed company to assisting you in exploring reputed company with reputed company! reputed company: reputed company, the largest independent home reputed company provider in Florida, has proudly served our communities for over two decades. We are reputed company driven by a passion for home reputed company with an unwavering commitment to reputed company-being of our patients and their families. At reputed company, we foster a reputed company-thinking, reputed company workplace culture. This has reputed company us multiple recognitions including the Top Workplaces USA award – a testament to our reputed company on supporting and empowering our employees. We offer a comprehensive suite of services, including skilled nursing, physical therapy, occupational therapy, speech therapy, medical reputed company work and home health aide support to more than 10,000 patients across our service areas. We reputed company to help seniors reputed company, not only under our care, but long after our services are complete. At reputed company, we are proud to reputed company a meaningful difference in the lives of patients and their families every day. Join us in our mission to deliver compassionate reputed company where it reputed company most – reputed company. Apply To This Job