Reimbursement Specialist – Home Health Exp Preferred

🔥 14 hours ago

🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Addus HomeCare

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1979

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance • Home Health

Addus HomeCare is a provider of quality in-home supportive services that enable individuals to maintain their health and independence while remaining in their homes. With over 40 years of experience, Addus offers a range of services including in-home care, home health, and hospice care to patients across various states. Their dedicated caregivers focus on providing compassionate support tailored to the unique needs of each individual, ensuring comfort and confidence for patients and their families.

📋 Description

• Investigate insurance benefits for new referrals • Assign and pursue collections with a variety of payers • Request authorizations and submit claims • Interpret patient insurance, prescription, and other health-related documentation • Conduct medical insurance verifications and investigations for commercial and government payors • Communicate with insurance companies, patients, providers, and prescribers to coordinate reimbursement and access solutions • Review unpaid accounts, determine status, and take appropriate action to ensure payment • Review claims for compliance and completeness before submission • Research alternative funding options to reduce patients’ financial burden • Handle high call volumes • Coordinate care with internal and external departments • Maintain confidentiality of sensitive information • Maintain regular, predictable, consistent attendance and flexibility to meet department needs • Follow applicable regulations, policies, procedures, and standards • Participate in continuous quality improvement • Perform other duties as assigned

🎯 Requirements

• High school diploma or equivalent is required • Undergraduate degree is preferred • 5 years of healthcare collections/billing experience preferred • Strong understanding of hospice billing regulations (Medicare, Medicaid, commercial) • Ability to read and interpret EOBs, remittances, and denial codes • Effective payer follow-up and escalation strategies • Ability to resolve claim holds, rejections, and denials • Ability to identify trends in denials or delays • Root-cause analysis to prevent recurring issues • High attention to detail to ensure clean claims • Ability to work AR reports and aging summaries accurately • Clear, professional communication with internal teams and payer representatives • Ability to explain payer issues in plain, understandable language • Quick and accurate alphanumeric data entry skills • Computer proficiency; MS Office and web-enabled applications strongly preferred • Customer service skills required • Ability to plan and organize work effectively and ensure completion • Ability to meet productivity requirements • Self-starter with exceptional organizational and follow-through skills • Ability to work independently and in a team environment • Must follow Medicare, Medicaid, and HIPAA regulations and requirements

🏖️ Benefits

• Medical, Dental and Vision Benefits • Continued Education • PTO Plan • Retirement Planning • Life Insurance • Employee discounts • Remote work schedule