Third Party Billing Specialist - Home Health

BHI Senior Living operates Life Plan Communities that combine vibrant lifestyles with comprehensive care and long-term security for residents. The organization is committed to excellence, compassion, and innovation, with a mission to positively impact the lives of older adults.

As a Home Health Billing Specialist, you will support the financial strength of Care Plus Home Health through accurate billing, compliance, timely follow-up, and effective revenue cycle management. You will manage billing across multiple payors, resolve claim issues, monitor accounts receivable, and collaborate with clinical, intake, and operational teams to keep billing processes running smoothly.

In This Role You Will

• Maintain current knowledge of home health billing regulations, reimbursement methodologies, and payor-specific requirements.
• Prepare, review, and submit accurate claims for assigned payor sources.
• Monitor claim status and address rejections, denials, and payment variances.
• Follow up on outstanding accounts receivable to maximize reimbursement.
• Post payments, adjustments, refunds, and recoupments accurately.
• Reconcile billing activity and payments to ensure accurate patient accounts and revenue reporting.
• Review insurance verifications and authorizations to ensure proper billing.
• Collaborate with intake, clinical, scheduling, and operations staff to resolve billing discrepancies.
• Respond to billing inquiries from patients, families, insurance carriers, and other stakeholders.
• Identify denial and underpayment trends and report findings to leadership.
• Assist with month-end billing processes, A/R reviews, and revenue cycle reporting.
• Maintain organized billing records in accordance with company and regulatory requirements.
• Participate in audits and compliance reviews.
• Protect patient confidentiality and comply with HIPAA and privacy policies.
• Assist with special projects and process improvements.