Join Pinnacle Home Care, Florida’s largest independent Medicare-certified home health provider, and support compassionate, patient-centered care delivered at home.
This role is focused on Medicare home health reimbursement and claims management. You will work claims through DDE FISS, manage NOAs and final claims under PDGM, resolve claim edits and RTP statuses, reconcile remittances, and partner with clinical, coding, and operations teams to ensure accounts are billable and compliant.
Requirements & Qualifications
Qualifications
- 3+ years of home health billing experience with hands-on DDE FISS.
- Strong knowledge of PDGM billing, NOA rules, LUPA, PEP, outlier logic, condition and occurrence codes, revenue codes, and TOBs 322/329.
- Experience researching and correcting RTP claims in DDE, including HIQA/HIQH inquiry and claim history.
- Experience with EDI transactions: 837I, 835, and 276/277.
- Working knowledge of MACs such as CGS, Palmetto, Noridian, or equivalent, plus major Managed Care portals.
- Detail-oriented with urgency and a commitment to clean claim submission.
- Strong written documentation skills for every account handled.
Benefits & Perks
Benefits
- Personalized, one-on-one care environment.
- Growth and stability with an established home health agency.
- Free continuing education units (CEUs) for professional development.
- Competitive benefits and employee referral rewards.
- Recognized workplace culture and industry excellence.
- Flexible scheduling.
- Supportive, collaborative team culture.
Location
Florida, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
2 months ago