A Home Health Claims/AR Resolution Specialist ensures the outstanding revenue for services provided by home health agencies is collected and reimbursed appropriately.  

Responsibilities and Duties:

• Obtaining claim status from insurance plans via phone and/or online portals

• Reviewing medical insurance claims for resolution and payment in a timely manner for maximum reimbursement

• Analyzing remittance advices to ensure accurate and timely posting of rejections, payments, and contractual adjustments

• Posting payments received and adjudicating accounts

• Maintaining a working knowledge of payer practices and reimbursement methodologies

• Becoming a subject matter expert in assigned A/R responsibilities

• Researching, compiling, and responding to documentation requests from insurance carriers

• Establishing and maintaining positive working relationships with agencies

• All other duties as assigned

Competencies:

To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this position.

• Proficient in mathematical, verbal, written, and computer skills, as well as reasoning ability
• Excellent communication, organization, and follow-up skills
• Ability to handle multiple assignments simultaneously
• Attention to detail and the ability to work independently

Job Qualifications:

• Previous medical accounts receivable experience required
• Knowledge of home health operations preferred

Physical Requirements:

• Regularly required to walk, sit, stand, bend, reach, lift, and move about
• Ability to communicate effectively, both orally and in writing.
• To perform other duties as required