Home Health Billing Manager

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Location Tarlani Healthcare Job Type Full-Time Shift Days Exempt Status Non-Exempt Job Description Summary Director of Revenue Cycle / Home Health Billing Director – responsible for overseeing all billing, collections, and revenue cycle operations for home health services. Essential Job Functions / Responsibilities Reimbursement through efficient billing and collections operations and effective accounts receivable management. Oversight and approval of claims audits and processing. Conduct final billing audit and issue assignments to pre-billing team when findings require further documentation. Monitoring and reporting Medicare and Medicaid regulatory updates. Comprehensive working knowledge of payer contracts and ensuring that payers are billed according to contract provisions. Represent and act on behalf of the agency in resolving conflicts with payers. Comprehensive understanding of government billing regulations, including Medicare and Medicaid, and serve as a resource for agency personnel. Aged accounts receivables: resubmit bills to overdue accounts, submit seriously overdue accounts to collection agencies, and prepare bad debt reports for weekly meetings. Gather, collate, and report key billing information to the billing team. Work with Executive Leadership Team in strategizing monthly, quarterly, and annual goals for optimized billing efficiency. Successfully reconcile the billing system reports with the general ledger. Reconcile Medicare quarterly reports produced by the fiscal intermediary with the billing information system. Use and maintain a comprehensive working knowledge of the billing information system, including upgrades and enhancements. Cash receipts and bank deposits according to policy. Maintain positive working relationships with patients, family members, payers, and referral sources. Maintain billing and patient accounts record systems in accordance with generally accepted accounting principles and in compliance with state, federal and Joint Commission regulations. Protect confidentiality of patient and agency information through effective controls and direct supervision of billing operations. Day‑to‑day department operations: assign work list files to billing staff. Train new staff on all systems. Supervise contact with guarantors and third‑party carriers regarding account resolution. Lead special projects related to billing and payment issues. Evaluate account follow‑up activity and conduct quality reviews. Patient account review and provide feedback to financial counselors to improve performance and quality assurance. Identify denial trends, root causes, and action steps to correct them. Lead internal and external financial and regulatory/compliance audits, including subsequent monitoring. Third Party Claims Processing Verify all claim billing information in EMR and contact appropriate personnel to obtain missing or unclear billing information. Document all tasks in EMR, including notes/history. Review all funding invoices to determine correct billing method. Complete claim form through EMR database or internet website, ensuring all required fields are accurate and attach required documentation for payment. Process denied and unpaid claims: determine next course of action, which may require rebilling missing claims, denied claims, or sending additional information on pending claims. Complete all necessary follow‑up in a timely manner so the payment process is not delayed; stay current on follow‑ups to meet billing deadlines. Interact with customers regarding all billing matters via phone, email, or regular mail promptly and courteously. Relate changes in Medicaid, MCO, Medicare, HMO regulations discovered by claim denials to all pertinent personnel, including other billing employees or management. Identify issues at the claims portion that would affect the prior authorization portion or other interconnected areas. Bring changes needed on a prior authorization before a claim can be processed to management’s attention. Handle accounting to collection agency, all cash posting and all cash undistributed functions. Relay updated information regarding state policy changes to the department. Perform other duties/projects assigned by management. Qualifications Related Bachelor’s degree. Two or more years of healthcare professional billing experience in Home Health (required). Two or more years of revenue cycle management in home health. 5–7 years of analytical experience, including claims review. Proficiency with Microsoft Office. Excellent communication skills. Ability to work well with a high degree of autonomy. Detailed knowledge of Medicare and private insurance patient billing regulations contained in Government Manuals. Detailed knowledge of covered and non‑covered procedures, patient responsibilities, and appeal processes. Skill in reading and comprehending medical billing policies and procedures appearing in billing manuals. Medicare billing for Home Health/Hospice knowledge (required). Benefits 401(k) Dental insurance Health insurance Paid time off Vision insurance Schedule Monday to Friday, 9:00am–5:30pm Education Bachelor’s (Required) Experience Home health billing: 2 years (Required) Work Location In person #J-18808-Ljbffr TARLANI Healthcare