The Billing Coordinator is responsible for performing all billing functions for the agency, ensuring claims are submitted accurately and on time to all payers.
Responsibilities
Prepare, review, and accurately submit institutional claims to Medicare, Medicaid, and all commercial insurance carriers via electronic submission.
Post all insurance and patient payments, adjustments, and denials to the correct patient accounts in the EMR system, ensuring timely and accurate reconciliation.
Ensure the correct use of ICD-10 diagnosis codes and revenue codes on all claims to comply with payer requirements and minimize claim rejections.
Work closely with the Collections team on accounts where payment has been delayed, short‑paid, or denied, providing necessary documentation to facilitate recovery.
Conduct thorough pre‑billing audits to verify patient eligibility, authorization validity, and documentation completeness before claim submission.
The Billing Coordinator is responsible for performing all billing functions for the agency, ensuring claims are submitted accurately and on time to all payers, with deep knowledge of home health and hospice billing rules.
Responsibilities
Prepare, review, and accurately submit institutional claims (e.g., UB-04s/CMS-1450s) to Medicare, Medicaid, and all commercial insurance carriers via electronic submission.
Ensure the correct use of revenue codes on all claims to comply with payer requirements and minimize claim rejections.
Work closely with the Collections team or perform initial follow-up on accounts where payment has been delayed, short-paid, or denied.
Conduct thorough pre-billing audits to verify patient eligibility, authorization validity, and complete documentation before claim submission.
Stay current on all federal and state regulations, including the Patient-Driven Groupings Model (PDGM) for Home Health and the Hospice payment rates.
Supervisor responsible for managing daily operations of scheduling and authorization positions within Revenue Cycle, overseeing staff, compliance, training, and reporting.
Responsibilities
Manage daily operations of scheduling and authorization positions
Conduct employee evaluations, disciplinary action, interviewing, hiring, and termination
Ensure compliance with CMS, commercial and third‑party payers, EMTALA, and Joint Commission rules
Stay abreast of computer system changes and assist during implementation
Develop and execute productivity and quality reports
Requirements
High school graduate or equivalent
Bachelor's degree in business administration or healthcare related field
Investigate complex hospital and health plan claims to understand how accounts move through billing, submission, adjudication, payment, denial, and appeal. Identify reimbursement and pricing discrepancies and develop investigative reports and appeal narratives.
Compensation
$74,000.00 - $135,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan.
Responsibilities
Trace disputed hospital and health plan claims through coding, billing, submission, payer edits, adjudication, payment posting, denials, recoupments, and appeals to establish the claim history.
Investigate pricing and reimbursement discrepancies by comparing billed charges, payer contract terms, rate schedules, expected allowed amounts, and actual payments; identify incorrect rates, adjustments, and payment logic.
Interpret provider agreements, reimbursement policies, and inpatient and outpatient payment methods, including DRG/APR-DRG, APC, case rates, fee schedules, and contractual carve-outs.
Review UB-04/CMS-1450 and CMS-1500 claims, 837/835 transactions, explanations of benefits, remittance advices, account notes, and payment histories to reconcile claim-level evidence.
Research denial and adjustment reasons using CARC/RARC codes, payer policies, coding guidance, denial letters, medical records, and prior appeal correspondence.
Requirements
Bachelor's degree in Accounting
Finance
Health Information Management
Corp Customer Service Rep 2, Business Office, FT, 08A-4:30P
Responsible for validating patient identity to comply with HIPAA Regulations, analyzing patient balances, reviewing billed services, and assisting with customer resolutions through phone calls and mail processing.
Compensation
Estimated pay range for this position is $20.42 - $25.93 / hour depending on experience.
Responsibilities
Validating patients identity to comply with HIPAA Regulations
Analysis of patient balances
Detail review of services billed
Validating correct patient/insurance and demographic information
Identifying customers concern and assisting with resolution including follow up with other departments (Financial Assistance Program, Financial Assistance Department, Charge Review Department, Patient & Guest Services, Special Handling, UR, CPO and Claims Management Department)
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