Reimbursement Specialist – Home Health & Hospice Collections Exp

This is a fully remote position, open to applicants in Texas.

📋 Description

• Manage billing and revenue cycle operations for home health and hospice services.

• Carry out insurance benefit investigations for new referrals.

• Oversee and assign collections across various payers.

• Submit authorization requests and claims efficiently.

• Analyze patient insurance, prescription, and other health-related documents.

• Perform medical insurance verifications and investigations for both commercial and government payors.

• Interact with insurance companies, patients, providers, and prescribers to facilitate reimbursement and access solutions.

• Review unpaid accounts, assess account status, and take necessary actions to secure payment.

• Evaluate claims for compliance and completeness prior to submission.

• Investigate alternative funding options to alleviate patients' financial burdens.

• Manage high volumes of calls effectively.

• Coordinate care among internal and external departments.

• Uphold confidentiality while handling sensitive information.

• Ensure consistent attendance and punctuality.

• Comply with organizational regulations, policies, procedures, and standards.

• Perform additional tasks as assigned.

⛳️ Requirements

• A high school diploma or equivalent is mandatory.

• An undergraduate degree is preferred.

• A minimum of 5 years of experience in healthcare collections/billing is preferred.

• Strong knowledge of hospice billing regulations, including Medicare, Medicaid, and commercial payors.

• Capability to read and interpret EOBs, remittances, and denial codes.

• Effective strategies for payer follow-up and escalation.

• Ability to resolve claim holds, rejections, and denials.

• Skill in identifying trends in denials or delays.

• Conduct root-cause analysis to prevent recurring issues.

• Exceptional attention to detail to ensure clean claims.

• Ability to accurately work with AR reports and aging summaries.

• Clear and professional communication with internal teams and payer representatives.

• Ability to explain payer issues in a straightforward and understandable manner.

• Quick and precise alphanumeric data entry skills.

• Proficiency in computer applications; MS Office and web-enabled applications are highly preferred.

• Customer service skills are essential.

• Ability to effectively plan and organize work to ensure completion.

• Capability to meet all productivity requirements.

• Ability to work independently as well as within a team environment.

• Outstanding organizational and follow-through skills.

• Must adhere to Medicare, Medicaid, and HIPAA regulations and requirements.

🏝️ Benefits

• Medical benefits.

• Dental benefits.

• Vision benefits.

• Continued education opportunities.

• Paid Time Off (PTO) Plan.

• Retirement planning options.

• Life insurance coverage.

• Employee discounts.