Under general supervision, the Home Health Billing Specialist primary responsibilities will include receiving and posting payments on accounts, processing refunds, adjusting customer invoices, insurance claim processing, knowledge of home health and DME, and managing accounts. You will also be responsible for researching and resolving discrepancies and keeping accurate accounting records. You will play a crucial role in ensuring the accurate and efficient recording of all incoming payments and transactions within our organization. The position encompasses business office responsibilities related to patient accounts, including charge import, appeals, diagnostics and procedural coding, and claim follow-up with third-party payers to achieve a zero-balance resolution.

Functions
Cash Posting Portion
• Payment Posting: Accurately post payments received from various sources, including checks, electronic transfers, and credit card payments. Maintain and work unapplied cash and post legacy cash, review adjustments for accuracy, and obtain approvals where appropriate.
• Reconciliation: Reconcile posted payments with bank deposits and statements, ensuring proper allocation and resolution of discrepancies.
• Reporting: Prepare regular reports on cash receipts, outstanding balances, and aging accounts.
• Collaboration: Liaise with other departments, such as accounts receivable, billing, and customer service, to resolve payment-related issues and improve cash flow processes.
• Compliance: Ensure compliance with regulatory requirements and internal controls related to cash handling and financial reporting. Assist with internal and external audits by providing documentation and supporting evidence as needed.

Billing / Follow-up Portion
• Initiate correction on all claims with errors by the designated time
• Follow up on any correspondence that may have been received on that day or the previous day
• Cross train on billing all lines of business to the different payers
• Pull listing of all accounts assigned to be follow up by specific payer
• Diagnostic and procedural coding
• Responsible for the resubmission of primary, secondary, and tertiary claims per respective regulations and policies.
• Communicate with third-party representatives as necessary to complete claims processing and /or resolve problem claims.
• Follow-up daily on post processing activity including but not limited to, rejected billings, adjustments, and rebilling, and denied claims for accounts.
• Maintain accounts receivable detail of their accounts through tasking.
• Maintains standards per payer for percentage accounts >90 days.
• Works minimum standard number of accounts per payer per day.
• Meets or exceeds collection goals by payer each month.
• Works all assigned accounts as assigned, depending on balance.
• Complete appeals as required.
Additional Duties
• Works all assigned accounts as assigned, depending on split.
• Participates in educational activities and attends monthly department staff meetings.
• Maintains confidentiality: adheres to all HIPAA guidelines/regulations.
• Other duties as assigned from time to time.
• Attend educational activities and monthly department staff meetings
• All other issues as assigned.

Education
• High School Diploma or GED

Minimum Work Experience
• Six months previous experience in registration, cash posting, billing and collections, financial counseling, or customer service preferred

Required Skills, Knowledge, and Abilities
• Knowledge of medical terminology preferred
• Basic computer proficiency
• Typing speed: minimum 40 WPM
• Familiarity with CPT and ICD-9 coding is helpful
• Cash posting
• Auditing
• Accounting / Reconciliation
• Good written and verbal communication skills are essential for account follow-up