Home Health Biller

Position Summary:

The Home Health Biller is responsible for ensuring accurate and timely billing of home health services, processing claims, and following up on payments. This role involves working closely with clinical staff, insurance companies, patients, and families to ensure proper reimbursement and compliance with billing regulations.

Responsibilities:

1. Billing and Claims Processing

• Prepare and submit claims for home health services to Medicare, Medicaid, private insurance, and other payers.

• Verify accuracy of billing information, including coding, patient data, and service details.

• Process electronic and paper claims in accordance with payer requirements and deadlines.

2. Accounts Receivable Management:

• Track claims through the payment process and resolve any denials or discrepancies.

• Follow up on outstanding claims, appeals, and corrections to ensure timely payment.

• Monitor accounts receivable aging reports and take appropriate action to reduce outstanding balances.

3. Compliance and Accuracy:

• Ensure all billing practices comply with Medicare, Medicaid, and private insurance regulations.

• Maintain up-to-date knowledge of billing guidelines and changes in home health regulations.

• Audit documentation to ensure it supports billed services and coding.

4. Coordination and Communication:

• Work closely with clinical staff to resolve documentation or coding issues.

• Communicate with insurance companies and patients regarding billing questions or concerns.

• Provide detailed billing summaries and reports to management as requested.

5. Documentation and Record-Keeping:

• Maintain accurate and organized billing records and files.

• Update patient records with billing and payment status.

• Ensure confidentiality and security of all patient information (HIPAA compliance).

6. Reporting:

• Generate billing reports, including revenue summaries, outstanding claims, and payment trends.

• Provide regular updates to management on billing status and any issues impacting reimbursement.

Qualifications:

Education:

• High school diploma or equivalent; associate or bachelor’s degree in business, healthcare administration, or related field preferred.

Experience:

• Minimum of 1-2 years of experience in home health billing or medical billing.

• Familiarity with Medicare, Medicaid, and private insurance billing guidelines.

Skills:

• Proficiency in billing software and electronic medical records (EMR) systems.

• Strong knowledge of medical terminology, ICD-10, and CPT codes.

• Excellent organizational skills and attention to detail.

• Effective communication and problem-solving skills.

• Ability to work independently and meet deadlines.

Preferred Qualifications:

• Certification in medical billing (e.g., Certified Medical Biller – CMB).

• Experience with Medicare Home Health PPS (Prospective Payment System).

• Knowledge of OASIS (Outcome and Assessment Information Set) documentation.

Working Conditions:

• Office-based position with potential for remote work based on agency policies.

• Standard working hours; occasional overtime may be required during billing cycles or audits.

Reporting:

Reports to the Billing Manager or Director of Finance.

Flexible work from home options available.