
US Home Health Billing Professional
2 days ago
We are seeking a detail-oriented Home Health Billing Specialist to support US-based home health agencies. The ideal candidate will have hands-on experience in processing claims under Medicare, Medicaid, and commercial payers with a strong grasp of PDGM, OASIS, and HIPPS codes.
Key Responsibilities:- Review and validate clinical and administrative documentation (e.g., OASIS, Plan of Care, Face-to-Face documentation) before billing.
- Accurately generate and submit RAPs, Final Claims, NOAs (Notice of Admission), and NOEs (Notice of Election) through Medicare DDE, clearinghouses, or EHR systems (e.g., Kinnser, WellSky, Axxess).
- Assign appropriate HIPPS codes and billing modifiers based on clinical inputs and assessments.
- Track and follow up on unpaid or denied claims; initiate appeals and resubmissions as necessary.
- Maintain AR follow-up and timely posting of payments, adjustments, and write-offs.
- Communicate proactively with US-based teams (Billing, Clinical, QA) to resolve claim issues.
- Stay current with CMS and payer-specific updates impacting home health billing.
- Education: College graduate with preference for medical or business-related courses.
- Experience: Minimum 1 year experience in US home health billing.
- Technical Skills:
- Familiar with Medicare billing guidelines and the PDGM model.
- Proficient in home health EMRs (e.g., WellSky, Kinnser, Axxess).
- Experience using DDE/FISS and/or medical billing clearinghouses.
- Working knowledge of HIPPS codes, CPT/HCPCS, and ICD-10.
- Soft Skills:
- Excellent English communication skills (written and spoken).
- High attention to detail and organizational skills.
- Ability to work US business hours (Eastern or Central time zones).
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