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Billing Specialist

HomeCare Maryland is looking for a full-time Billing Specialist to join our team. At HomeCare Maryland we offer a comprehensive benefits package to eligible employees.

 

About HomeCare Maryland: HomeCare Maryland, LLC, a LifeBridge Health Partner, is a Medicare-certified and licensed home health care provider in the state of Maryland serving Baltimore City, Baltimore County, Harford County, Carroll County, Cecil County, and Frederick County areas. At HomeCare Maryland our committed staff provides individuals with health care and health related services in their own homes. As a result, many people can lead healthier, happier more independent lives. Our mission is to be the premiere home healthcare provider throughout Maryland. We seek to treat all of our employees, patients and others with dignity and respect and to respond to any challenges we encounter in serving our patients with the highest level of professionalism.

 

Summary of Position: The HomeCare Maryland Billing Specialist will perform all billing tasks necessary to produce and submit clean and timely claims for reimbursement from multiple payers including Medicare, Medicaid, Bravo, CareFirst and Riverside. This position will also perform accounts receivable analysis and collection activities to ensure HomeCare Maryland is reimbursed appropriately for the services provided to our patients. Responsible for working with third party payers and case management to obtain ongoing authorization for home care services. Responsible for tracking authorization for home care patients. Utilizing agency software to enter authorization periods, sending notification to staff and retrieving visit information as required. Support medical records as needed. This is an advanced working position that requires work of considerable difficulty, including reviewing patient health information for data retrieval, analysis, claims processing and quality.

 

Essential Functions:

  • Verify patient insurance eligibility, coverage, benefits and preauthorization/authorization for multiple payers.
  • Update patient insurance information in system as required.
  • Perform pre-billing edits for all claims to be submitted to multiple payers to ensure clean claim submissions.
  • Creates electronic claims files and submit to clearinghouse or payer for multiple payers.
  • Resolve all claims submission errors and resubmit as required.
  • Create and submit UB04 paper claims as required.
  • Monitor all electronic and paper claims submission, processing and reimbursement to ensure timely reimbursement.
  • Responsible for the collection of all accounts receivable and adhere to company collection requirements.
  • Post payments and adjustments electronically and manually as required.
  • Analyze complex medical records and identify billable services.
  • Effectively oral and written communication with office staff, clinical staff, and third party payers about authorizations, billing and collections. Calculates authorizations to actual number of visits made to include date range. Maintains communication with CM, clinical manager or director with all authorization concerns.
  • Communicates with disciplines in reference to new or impending authorizations via telephone or email. Document all conversations related to insurance cases in case coordination note including: date, time, caller name, phone number, reference number and conversation/notification/outcome to ensure clear communication to all involved in case.
  • Follows up with insurance companies in a timely fashion to assure authorization process complete up to date and accurate.
  • Verify insurance eligibility and adjusts dates and authorization amount as needed for payments. Utilize insurance portals for eligibility and authorizations. Maintain up to date knowledge of all insurance changes or requirements.Meet with and report information about billing and accounts receivable to the management team;

Qualifications:

  • Three or more years Home Health billing and collections experience including Medicare, managed Medicare, Medicaid and private pay billing.
  • Experience working with Medicare’s Fiscal Intermediary Standard System (FISS); UB04 claims; electronic claims clearinghouse companies – Emdeon, eSolutions preferred.

Technical /Clinical Skills:

  • Basic clerical- general knowledge in one or more software, hardware or information systems such as, Microsoft Office and ability to learn departmental software.
  • An understanding of regulations, documentation and reimbursement requirements.
  • Efficient organization and time management skills
  • Effective communication skills

 

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HCM does not discriminate against any person on the basis of race, color, national origin, disability, or age in admission, treatment or participation in its programs, services and activities, or in employment. For further information about this policy, contact the agency's administrator at 410-566-5015, TDD/MD Relay.

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