Billing & Reconciliation Representative

Become a part of our caring community and help us put health first
 

The Billing & Reconciliation Representative is responsible for identifying and resolving discrepancies between company records and those maintained by the Centers for Medicare and Medicaid Services. This role encompasses a range of moderately complex administrative, operational, and customer support tasks, including performing calculations and data analysis. Assignments are generally semi-routine in nature, requiring attention to detail and adherence to established procedures.

The Billing & Reconciliation Representative performs monthly account reconciliations, thoroughly documenting any issues identified and developing actionable plans to resolve them. This role is committed to delivering exceptional customer service by keeping all relevant stakeholders informed of account status updates. Responsibilities include correcting discrepancies related to enrollment and cash posting within the billing process and preparing comprehensive documentation to communicate account issues to management, market groups, and regional personnel. Decisions made in this position typically involve interpreting area or departmental policies and selecting appropriate methods for completing assignments. The role operates within established parameters to ensure work expectations and quality standards are met, while allowing for some discretion regarding prioritization and timing. Although standard policies and practices are followed, the position provides opportunities for interpretation and independent judgment.

Use your skills to make an impact
 

Required Qualifications

• Minimum of 3 years’ experience in the healthcare industry, with a strong understanding of medical terminology.

• Proven background in medical billing, specifically as an HME/DME biller, and demonstrated experience in account reconciliation.

• Advanced analytical and problem-solving abilities, with a track record of successfully identifying and resolving account discrepancies.

• Proficient in Microsoft Excel and familiar with financial or billing software systems.

• Highly detail-oriented, with excellent organizational and time-management skills.

• Capable of working independently with minimal supervision, while effectively managing multiple priorities.

• Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations is preferred.

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

• Bilingual (Spanish speaker)

Preferred Qualifications

• 3 to 5 years of professional experience in a related field.

• Foundational knowledge of accounting principles and practices.

• Hands-on experience with medical coding, including proficiency in ICD-10.

• Billing and coding certification

Additional Information

• Hybrid (3 days in office 2 from home)

• Location: 3325 Executive Way Miramar, FL 33025

• Required shift: 8:00a to 5:00p

• Overtime: Required

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$40,000 - $52,300 per year

 

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us
 

About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients’ homes. OneHome’s patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.

About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.