Job Responsibilities

Claims Processing & Billing

• Claim Submission: Prepare, review, and submit accurate, clean medical and insurance claims for home care services using Electronic Health Records EHR and specialized billing software.
• Eligibility Verification: Confirm client insurance coverage, secure necessary prior authorizations, and verify benefit eligibility prior to service delivery.
• Dispute Resolution: Monitor denied, rejected, or delayed claims; research discrepancies; and coordinate with insurance providers and state agencies to resolve billing issues.
• Payment Posting & Reconciliation: Post cash receipts, reconcile remittances against bank deposits, and track accounts receivable AR to minimize outstanding balances.
• Audit & Compliance Support: Prepare schedules, gather documentation, and provide analytical support for external annual audits.
• Process Improvement & Office Operations: Collaborate with the business management team to streamline operational procedures, support special projects, and maintain an efficient office environment.

Administrative Support

• Office Communication: Manage multi-line phone systems, route incoming electronic communications, and extend a professional, welcoming presence to visiting clients and guests.
• Data & Records Management: Maintain confidential client, clinical, and caregiver records in strict compliance with HIPAA and agency standards.
• Scheduling Assistance: Assist with intake appointments, patient scheduling, and caregiver-patient matching as needed.
• Reporting: Compile and generate regular financial, billing, and operational metrics reports for review by the Agency Administrator and Finance Director.
• Training and Support: Support agency operations by completing required training and providing coverage for other staff as needed.