Revenue Cycle Specialist
On-siteMooresville, North Carolina, United States
Job Summary
Process assigned Medicare, Medicaid, and Commercial claims accurately within payer timelines while tracking daily physician orders and signatures. Notify administration of missing documents, maintain required logs, and review Explanation of Benefits to determine payment posting or appeals. Identify payer behavior trends, report unexpected patterns to the Revenue Cycle Manager, and communicate with field staff regarding unbilled revenue. Follow up on outstanding billing items, manage clearinghouse edits, and participate in quality improvement activities related to billing performance. This role supports billing operations for a national leader in hospice and home health care, requiring experience with Homecare HomeBase and platforms like DDE or Waystar.
Required Qualifications
- Must be at least 18 years old
- High school diploma or GED
- Minimum of 2 years of experience in Home Health or Hospice billing
- Advanced Microsoft Office skills, including basic to advanced Excel capabilities
- Ability to work with confidential data and maintain accuracy in data entry
- Capable of working independently and collaborating with cross-functional teams
- Skilled at using multiple computer applications and clearinghouse platforms
- Familiarity with payer guidelines, filing limits, and billing edits
- Strong verbal and written communication skills for engaging with clinical staff
- Excellent troubleshooting and problem-solving skills
- Strong understanding of revenue cycle operations and medical billing workflows
- Comfortable managing a high volume of claims in a metrics-driven environment
Desired Qualifications
- Experience with Homecare HomeBase
- Experience with billing tools such as DDE, E-solutions, Waystar, and/or Nthrive
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