About this role
We are seeking an experienced and detail - oriented Home Health & Hospic e Medical Biller to join our Revenue Cycle team. In this critical role, you will be responsible for the accurate and timely submission of claims to Medicare , Medicaid , and private insurance payers for home health and hospice services. The ideal candidate brings a solid understanding of home health and hospice billing regulations , payer-specific requirements , and a commitment to compliance and clean cla im submission.
Key Responsibilities
- Prepare and submit accurate clai ms for home health (PPS/RAPs/Final Claims) and hospice services (NOE, election, revocation, and final claims) to Medicare, Medicaid, and commercial insurer s
- Process Reqtl8ts for /\.nticipah d Psym8ill,S;-fRAl¼}::3nd final claims in accordance with CMS timelines
- Revi ew Explanation of Benefits (EOBs) and Remittance Advices (RAs); post payments and adjustments accurately
- Identify, work, and resolve clai m denials , rejections , and underpayments through timely appeals and follow-up
- Verify patient eligibility, hospice election status, and benefit period information prior to billing
- Maintain working knowledge of OASIS assessments , physician orders , and their relationship to billing compliance
- Monitor accounts receivable aging reports and take proactive s teps to reduce outstanding balances
- Communicate with clinical staff, coders , and intake coordinators to reso l ve billing discrepancies
- Ensure compliance with Medicare Conditions of Participation (CoPs), HIPAA regulations, and agency policies
- Stay current on CMS rule cha nges , LCD / NCD updates, and s tate Medicaid billing requirements
- Generate and analyze billing report s; present finding s to management as needed
- Assist with internal and external audits as requested
Qualifications
- Minimum 2 years of medical billing experience specifically in home health and/or hospice
- Strong knowledge of Medicare home health Prospective Payment System (PPS) , PDGM , and hospice benefit billing
- Proficiency with EMR/billing software (e.g., Kinn se r , WellSky, Homecare Homebase , Matri xCa r e, or sim ilar )
- Famili ar it y with UB -04 claim forms and electronic claim submiss i on via clea r ing h ouses (e.g., Waystar , Change Healthc a re)
- Knowledge of HIPAA privacy and security regulations
- Strong attention to detail and orga ni zational sk ill s