Responsible for managing and resolving accounts receivable for home health and hospice claims, including follow-ups, denial resolution, and payer communication.
The AR Management Specialist is responsible for managing and resolving accounts receivable for home health and hospice claims after submission. This role focuses on timely follow-up, denial resolution, payer communication, and ensuring accurate reimbursement in compliance with Medicare, Medicaid, and commercial payer guidelines.
Key Responsibilities
• Follow up on submitted home health and hospice claims with Medicare, Medicaid, and commercial payers
• Investigate and resolve unpaid, underpaid, or denied claims in a timely manner
• Analyze Explanation of Benefits (EOBs) and remittance advice to identify discrepancies
• Submit claim corrections, rebills, and appeals as needed
• Communicate with payers via phone, portals, and written correspondence to resolve claim issues
• Maintain accurate documentation of all follow-up actions and payer communications
• Work closely with team leads for account resolution
• Monitor AR aging reports and prioritize accounts for follow-up
• Ensure compliance with Medicare, Medicaid, and payer-specific billing guidelines
• Meet productivity and AR resolution benchmarks
Qualifications
• Minimum of 2 years experience in AR management, medical billing, or revenue cycle (home health and/or hospice preferred but not mandatory)
• Strong knowledge of Medicare, Medicare Advantage, Medicaid, and commercial payer processes
• Experience with claim follow-up, denials, and appeals
• Familiarity with home health and hospice billing regulations (OASIS, NOA/NOE, PDGM, hospice benefit periods preferred)
• Proficiency with billing software and payer portals
• Strong attention to detail and problem-solving skills
• Excellent communication and documentation skills
Preferred Skills
• Experience with Medicare replacements and managed care plans
• Understanding of payer authorization and eligibility requirements
• Ability to manage high-volume AR and meet deadlines independently
• Knowledge of compliance and audit readiness standards
Key Responsibilities
• Follow up on submitted home health and hospice claims with Medicare, Medicaid, and commercial payers
• Investigate and resolve unpaid, underpaid, or denied claims in a timely manner
• Analyze Explanation of Benefits (EOBs) and remittance advice to identify discrepancies
• Submit claim corrections, rebills, and appeals as needed
• Communicate with payers via phone, portals, and written correspondence to resolve claim issues
• Maintain accurate documentation of all follow-up actions and payer communications
• Work closely with team leads for account resolution
• Monitor AR aging reports and prioritize accounts for follow-up
• Ensure compliance with Medicare, Medicaid, and payer-specific billing guidelines
• Meet productivity and AR resolution benchmarks
Qualifications
• Minimum of 2 years experience in AR management, medical billing, or revenue cycle (home health and/or hospice preferred but not mandatory)
• Strong knowledge of Medicare, Medicare Advantage, Medicaid, and commercial payer processes
• Experience with claim follow-up, denials, and appeals
• Familiarity with home health and hospice billing regulations (OASIS, NOA/NOE, PDGM, hospice benefit periods preferred)
• Proficiency with billing software and payer portals
• Strong attention to detail and problem-solving skills
• Excellent communication and documentation skills
Preferred Skills
• Experience with Medicare replacements and managed care plans
• Understanding of payer authorization and eligibility requirements
• Ability to manage high-volume AR and meet deadlines independently
• Knowledge of compliance and audit readiness standards
Joining us is more than saying “yes” to making the world a healthier place. It’s discovering a career that’s challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. If this sounds like the workplace for you, apply now! We commit to respond to every applicant.
Top Skills
Billing Software
Payer Portals
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