Home health Billing Specialist

Biller Position Summary

The Home Health Biller is responsible for the accurate and timely preparation, submission, and follow-up of claims for home health services to Medicare, Medicaid, private insurance, and other third-party payers. This role ensures compliance with all federal, state, and payer-specific billing regulations and supports the agency’s revenue cycle by minimizing denials and maximizing reimbursement.


Key Responsibilities

· Claims Preparation & Submission

o Prepare and submit electronic and paper claims for all home health services (Medicare, Medicaid, private insurance, self-pay).

o Verify accuracy of OASIS/485 and visit documentation to match billed services.

o Ensure all billing is compliant with CMS regulations and payer guidelines.

· Payment Posting & Reconciliation

o Post payments and adjustments to patient accounts in the billing system.

o Reconcile deposits with remittance advices and resolve discrepancies.

· Denial Management & Follow-Up

o Review and respond to claim rejections or denials; correct and re-submit claims.

o Communicate with payers to resolve unpaid or underpaid claims.

· Compliance & Documentation

o Maintain knowledge of Medicare Conditions of Participation and HIPAA.

o Ensure accurate patient demographics, authorizations, and physician orders are on file before billing.

· Internal Coordination

o Work closely with clinical, intake, and scheduling teams to ensure complete and accurate documentation.

o Provide management with regular reports on billing activity, aging accounts, and collection status.


Qualifications

· degree in accounting, healthcare administration, or related field preferred.

· 1–3 years of billing experience in home health, hospice, or healthcare revenue cycle.

· Familiarity with Medicare/Medicaid regulations and common clearinghouse platforms.

· Strong knowledge of EHR/billing software (e.g., WellSky, Axxess, Kinnser, or similar) we use axxess.

· Excellent attention to detail and ability to meet deadlines.

· Strong communication and problem-solving skills.

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Physical & Work Requirements

· Standard office environment with prolonged computer use.

· Ability to handle sensitive patient and financial information with strict confidentiality.

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Key Competencies

· Knowledge of medical terminology and home health coding practices.

· Analytical thinking and accuracy.

· Customer service orientation with payers and internal staff.

· Ability to adapt to regulatory changes.