Billing Specialist

• Prepare and submit accurate Medicare, Medicaid, and Commercial insurance claims through Home Care Home Base (HCHB) and Waystar billing platforms. Ensure compliance with Patient -Drive Groupings Model (PDGM) billing rules and payer-specific guidelines. 

• Monitor, review, and follow up on claims, including aging accounts receivable, denied or rejected claims. Resubmit overdue accounts and escalate seriously overdue accounts to collections when necessary.

• Collaborate with cross-functional teams including Intake, Authorization, Clinical, Operations Support Office (OSO), and regional staff to ensure billing accuracy and resolve any discrepancies. Respond to billing inquiries from internal and external stakeholders. 

• Participate in Accounts Receivable (AR) and Billing Accountability Meetings (BAM). Prepare and review relevant reports such as billing summaries, bad debt, and outstanding AR to ensure accuracy and completeness. Assist with audits and provide documentation as needed. 

• Other duties as assigned related to billing and revenue cycle operations. 

REQUIREMENTS AND SPECIFICATIONS 

• Bachelor’s Degree Business Administration or related field Preferred 

• Minimum 2 years of billing experience in Home Health and/or Hospice. 

• 2-5 years of experience preferably in Home Care 

• Strong written and verbal communication skills 

• The Billing Specialist must have Home Health and Hospice billing experience. 
• Proficiency with HCHB EMR, clearinghouses such as DDE and Waystar. 
• A strong understanding of Medicare, Medicaid, and commercial insurance billing. 
• Excellent organizational, analytical, and communication skills.
• Ability to work independently and manage multiple priorities in a deadline-driven environment.