Home Health & Hospice Biller

HOME HEALTH & HOSPICE BILLER POSITION SUMMARY The Home Health & Hospice Biller is responsible for accurate and timely billing and reimbursement activities for Home Health and Hospice services.

This position processes claims to Medicare, Medicaid, commercial insurance companies, managed care organizations, and other third-party payers.

The Biller ensures claims are submitted accurately, follows up on unpaid and denied claims, researches billing discrepancies, and works to maintain timely reimbursement and a healthy accounts receivable balance.

The Home Health & Hospice Biller works closely with clinical, intake, authorization, coding, medical records, and accounting personnel to ensure services are properly documented, authorized, coded, billed, and reimbursed in accordance with payer requirements and applicable regulations.

ESSENTIAL DUTIES AND RESPONSIBILITIES Billing and Claims Processing Prepare and submit accurate Home Health and Hospice claims to Medicare, Medicaid, commercial insurance companies, managed care organizations, and other third-party payers.

Review patient accounts and billing information for accuracy prior to claim submission.

Verify patient demographics, insurance coverage, payer information, authorization requirements, and applicable benefit information.

Ensure claims are submitted within payer and regulatory timely filing requirements.

Review claims for missing or incorrect information that could result in rejection or denial.

Enter and maintain billing information accurately within the electronic medical record and/or billing system.

Process corrections, adjustments, rebills, and replacement claims as necessary.

Monitor electronic and paper claim submissions and resolve claim transmission errors.

Maintain knowledge of Home Health and Hospice billing requirements, including Medicare and Medicaid requirements.

Review billing reports to identify outstanding, rejected, or unbilled claims.

Accounts Receivable and Collections Monitor accounts receivable and follow up on outstanding balances in a timely manner.

Review aging reports and prioritize accounts based on age, payer, balance, and likelihood of collection.

Contact insurance companies and other payers regarding unpaid or delayed claims.

Research and resolve payment discrepancies and underpayments.

Post insurance payments, contractual adjustments, denials, and other account transactions accurately.

Identify accounts requiring additional documentation or action from clinical or administrative staff.

Maintain appropriate documentation of collection and follow-up activities.

Escalate unresolved billing issues to the appropriate supervisor or manager.

Denials and Claim Resolution Research and resolve denied, rejected, and suspended claims.

Determine the reason for claim denial and take appropriate corrective action.

Prepare and submit corrected claims and appeals when appropriate.

Obtain supporting documentation needed for claim appeals.

Track denials and identify recurring b...