Billing Resolution Specialist - Home Health/Hospice
LifeCare Home Health FamilyAbout the role
Description
Join Life Care Home Health Family!
Serving Texas, Florida, Nevada, and Georgia, we provide skilled nursing, therapy, homecare, hospice, palliative care, and private duty services.
Why Work With Us?
- Nestmed AI Scribe: Less charting, more caring!
- Competitive pay, 401k, health & life insurance
- Flexible schedules & career growth opportunities
- Continuing education & recognition programs
- Supportive, family-like team culture
Make a difference in patients’ lives while enjoying work-life balance. Apply today and grow with us!
Position Summary
The Billing Resolution Specialist is responsible for monitoring, resolving, and coordinating follow-up on delayed, denied, or rejected insurance claims billed by a third-party billing company. This role serves as the internal owner of claim resolution, ensuring timely corrections, rebilling, and payment while working closely with clinical, intake, and billing partners.
Key Responsibilities
- Monitor A/R aging and identified claim issues related to eligibility, authorizations, Oasis, coding, documentation or timely filing.
- Partner with clinical, intake, authorization and QA teams to obtain required corrections, including Oasis updates, eligibility verification, authorization and payer corrections when applicable.
- Act as an internal liaison with the third-party billing company to ensure timely actions are taken to resolve delays.
- Push back when rebill timelines are missed; root causes are not documented; denials repeat without correction
- Escalate recurring issues and high-risk claims to Director of RCM and leadership
- Support revenue cycle improvement initiatives and assignments as needed
- Oversee adding of payers to the EMR; communicate payer specific requirements to appropriate teams
- Assist with processing approved write-offs and AR collections adjustments as needed.
- Assist as needed with patient invoicing
Requirements
Qualifications
- 3+ years home health billing, A/R, or claims follow-up experience
- Strong knowledge of Medicare Home Health billing (NOA, PDGM)
- Familiarity with payer denials and timely filing requirements
- Experience working with third-party billing vendors preferred
- Working knowledge of EMR ( HCHB, Wellsky/Kinnser/Consolo)
- Strong attention to detail and follow-through
Skills
- Well informed on compliance and payer requirements
- Claims analysis and problem resolution
- Vendor and cross-functional coordination
- Strong organizational and communication skills
Work Environment
- Office, remote, or hybrid setting depending on agency policy
- Standard business hours with flexibility based on workload
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