Billing and Denials Management Specialist (Homecare)

Overview

Amivie, LLC is seeking a skilled Denials Management Specialist to handle all aspects of home care billing denials, payment posting, and denial management for our home care services. The ideal candidate will have extensive experience working home care billing denials, a keen eye for detail, and the ability to work independently.

Responsibilities

 

1. Billing:

• Prepare and submit accurate and timely claims to Medicaid and VA andother payers for home care services provided.
•  Ensure compliance with all relevant billing regulations and guidelines.
• Maintain accurate records of billing activities and patient accounts.

2. Denials Management:

• Analyze denied claims to determine the root cause and take corrective actions to prevent future denials.
• Resubmit corrected claims and provide necessary documentation to support claim appeals.
• Communicate with insurance companies to resolve outstanding issues and secure payments.

3. Payment Posting:

• Accurately post payments received from insurance companies and patients to the appropriate accounts.
• Reconcile accounts to ensure all payments are accounted for and discrepancies are resolved promptly.

4. Reporting and Analysis:

• Generate regular reports on billing activities, payment status, and denial trends.
• Provide insights and recommendations to improve billing processes and reduce denials.

Qualifications

• Minimum of 2-3 years of experience in medical home care billing denials, with a focus on home care services.
• Proficiency in billing software (e.g., WellSky) and electronic health records (EHR) systems.
• Strong understanding of insurance policies, procedures, and regulations related to home care billing denials.
• Experience with Virginia and or Minnesota home care billing denials is preferred.
• Excellent analytical skills with the ability to identify trends and issues in home care billing denials and denial data.
• Strong communication skills, both written and verbal, to interact effectively with insurance companies and team members.
• High degree of accuracy and attention to detail in all aspects of work.
• Ability to work independently and manage multiple tasks simultaneously.

Skills:

• Advanced proficiency in MS Office, particularly Excel.
• Familiarity with ICD-10, CPT, and HCPCS coding.
• Knowledge of HIPAA regulations and the ability to maintain patient confidentiality.
• Strong problem-solving skills and the ability to think critically.
• Problem solving and critical thinking skills.
• Ability to identify root causes and correct claims.
• Proficiency in submitting appeals.
• Skill and organization in monitoring timely filings.

Education:

• High school diploma or equivalent required; associate or bachelor’s degree in healthcare administration, finance, or a related field preferred.