Overview
A leading independent Medicare-certified home health provider in Florida is seeking a Reimbursement Analyst to join their team. This role focuses on supporting timely reimbursement and revenue cycle management through detailed account review and payer communication.
Responsibilities
- Perform daily collection activities for assigned accounts using internal and external resources such as databases, payer portals, and telephone contact.
- Review Explanation of Payments (EOPs), Explanation of Benefits (EOBs), Remittance Advices (RAs), and End of Month Bills (EOMBs) for accuracy and patient responsibility.
- Resolve denied or rejected invoices by preparing payer corrections and appeals according to payer plan requirements via electronic and paper processes.
- Ensure all reconciled items and past due balances are resolved through follow-up with payers and patients.
- Calculate expected reimbursement percentages based on contracted rates and document accounts accordingly.
- Utilize appropriate systems to actively contact payers and patients regarding account transactions.
- Respond promptly to inquiries, providing resolutions to concerns or discrepancies.
- Identify trends and opportunities, reporting data to the direct supervisor on the same day.
- Meet productivity goals set by the Billing/Reimbursement Manager.
- Communicate professionally with internal departments to resolve potential disputed items.
- Participate in payer webinars and conference calls to stay informed on billing and collection topics.
- Assist in training new accounts receivable personnel as needed.
- Comply with HIPAA regulations and maintain confidentiality of patient and organizational information.
- Perform additional duties as business needs evolve.
Qualifications
- High school diploma or equivalent.
- Minimum of 2 years of experience in revenue cycle collections.
- Strong knowledge of managed care, commercial insurance, and insurance portals.
- Proficient in interpreting insurance remittances and episodic billing methodologies such as PPS and PDGM.
- Skilled in Microsoft Office and general computer applications.
- Ability to prepare and analyze reports and business correspondence.
- Excellent organizational and time management skills with the ability to meet tight deadlines.
Compensation & Benefits
- Competitive benefits and perks, including an employee referral program.
Location
Equal Opportunity
The organization promotes an inclusive environment and is an equal opportunity employer. Discrimination or harassment based on race, religion, age, gender, national origin, disability, veteran status, or other legally protected characteristics is prohibited.