Billing Specialist (Home Health and Hospice)

Summary

Aegis Healthcare provides patient-focused healthcare services, including Home Health and Hospice. The Billing Specialist manages billing queues, claims, payer requirements, payment reconciliation, accounts receivable, denials, and issue resolution across assigned programs. The role also identifies recurring process failures, coordinates with operational teams, and reports billing and revenue-cycle performance to leadership.

Responsibilities

• Own assigned home health and hospice billing queues from eligibility and authorization review through final claim, payment, and account closure. Verify coverage, payer order, patient and provider information, contract terms, and payer specific billing requirements
• Prepare, submit, and track required Medicare notices, including home health Notices of Admission (NOAs), hospice Notices of Election (NOEs), and Notices of Termination or Revocation (NOTRs) when applicable. Monitor acceptance and resolve errors before deadlines
• Prepare and submit initial, interim, final, adjustment, and corrected Home Health and Hospice claims for all assigned payers. Check home health visits and payment periods, hospice days and levels of care, dates, codes, units, authorizations, rates, and claim attachments as applicable
• Apply current payer rules, state program requirements, contracts, clearinghouse edits, and internal policies. Track payer changes and identify when workflows or staff instructions need to change
• Check for required billing elements and documentation status, including orders, certifications and recertifications, face to face documentation where applicable, election documents, and plan of care status. Route clinical or coding deficiencies to the responsible team; do not create or alter clinical documentation
• Monitor OASIS and HOPE submission or acceptance status when it affects billing or reimbursement, and promptly escalate missing, rejected, or late items to the team that owns quality reporting
• Investigate clearinghouse and payer edits, returned claims, rejections, denials, underpayments, overpayments, authorization failures, eligibility conflicts, and payment discrepancies. Pursue each issue to resolution and document the cause, action, owner, and follow up date
• Coordinate documentation requests, additional development requests, medical reviews, appeals, and audit support within assigned billing scope; escalate clinical or legal determinations to QA and compliance
• Post and reconcile payments, remittances, contractual adjustments, and patient balances within assigned duties and approval controls. Investigate unapplied cash, credit balances, duplicate charges, missing claims, and invoice or charge discrepancies
• Work accounts receivable by aging, payer, and root cause; follow up on unpaid or partially paid claims and maintain a clear account note trail. Identify write offs or refunds for approval rather than approving them independently
• Provide billing leadership with regular reports on charges and claims billed, cash received, unbilled accounts, aging receivables, denials and rejections, notice timeliness, authorizations, held claims, and recurring causes of delay
• Flag urgent risks immediately, including notice or authorization deadlines, claims at risk of timely filing, material rate or billing errors, payer or system outages, and repeated documentation gaps
• Trace recurring problems to their source, such as intake data, authorization, visit capture, coding, documentation, claim setup, or payer mapping. Recommend a practical process fix, coordinate with the responsible owner, and check whether the fix reduced rework and delayed payment
• Partner with intake, QA, clinical operations, coding, IT or EMR support, and finance to resolve handoff problems. Maintain organized records of submissions, payer responses, and follow up

Skills

• At least three years of hands-on home health or hospice billing and revenue cycle experience, including substantial claim resolution and accounts receivable follow up
• Working knowledge of Medicare Part A, Medicaid, managed care or commercial payer billing, electronic claims, remittance advice, denials, authorizations, and required notices
• Ability to learn state specific programs and payer contracts
• Demonstrated success resolving complex payer issues and identifying repeat process failures
• Able to use claim and aging reports to explain the cause, financial impact, owner, and corrective action
• Proficiency with an electronic health record, clearinghouse or Medicare billing portal, spreadsheets, and secure handling of protected health information
• Strong organization, follow through, accuracy, and professional communication
• Comfortable raising an issue early and naming the owner and next action
• Experience with both service lines is strongly preferred
• Careficient experience is a plus

Qualifications

Must Haves

• At least three years of hands-on home health or hospice billing and revenue cycle experience, including substantial claim resolution and accounts receivable follow up
• Working knowledge of Medicare Part A, Medicaid, managed care or commercial payer billing, electronic claims, remittance advice, denials, authorizations, and required notices
• Ability to learn state specific programs and payer contracts
• Demonstrated success resolving complex payer issues and identifying repeat process failures
• Able to use claim and aging reports to explain the cause, financial impact, owner, and corrective action
• Proficiency with an electronic health record, clearinghouse or Medicare billing portal, spreadsheets, and secure handling of protected health information
• Strong organization, follow through, accuracy, and professional communication
• Comfortable raising an issue early and naming the owner and next action

Nice to Haves

• Experience with both service lines is strongly preferred
• Careficient experience is a plus

Benefits

• Career Longevity: Our average employee tenure is 5 years.
• Meaningful Work: Support the frontline clinical teams providing person-centered care to vulnerable populations.
• Employee Experience: Fun perks, rewards, and recognition programs.
• 22 days of PTO
• Medical, Dental, and Vision insurance options
• 401(k) with employer matching
• Life, Accident, and Disability Insurance
• Referral bonuses