Note: The job is a remote job and is open to candidates in USA. Pinnacle Home Care is Florida’s largest independent Medicare-certified home health provider, dedicated to delivering high-quality, patient-centered care. They are seeking a Billing Supervisor to oversee billing staff, ensure compliance with regulations, and manage the billing process effectively.
Responsibilities
- Supervise, train, and mentor billing staff, assigning work to ensure all claims are processed according to company guidelines
- Oversee the submission of Notice of Admissions (NOA), RAP (Requests for Anticipated Payment), and final claims in EMR systems
- Conduct regular audits of patient records to ensure compliance with Medicare regulations and all payer standards
- Monitor and reduce accounts receivable (A/R) days and denial rates, developing strategies to improve collections and reduce revenue leakage
- Review and resolve complex denied claims, submitting appeals and managing the follow-up process
- Generate and analyze daily/weekly/monthly billing reports to monitor trends and report to management
- Partner with clinical managers, nurses, and clinicians to ensure OASIS documentation and physician orders support accurate billing
- Assist in development of and enforce billing policies and procedures, keeping the team updated on payer changes
- Assign any Office Authorization as needed for patient care to continue without delay, until authorization has been submitted and returned with a decision
- Monitor Zendesk, WellSky fax inquiries, and incoming faxes throughout the day to update patient authorization status and adhere to any failed faxes in WellSky requiring more information to process authorization
- Analyze and reconcile complex issues and problems
- Prepare and analyze appropriate reports and other business correspondence
- Identify needs and opportunities and present them to the supervisor with recommended solutions
- Meet productivity goals assigned by the Authorization Supervisor
- Adhere to federal, state, and agency regulations and policies to maintain confidentiality of patients and agency information per HIPPA requirements
- Respond to all inquiries with a resolution to concerns and/or discrepancies
Skills
- High school diploma required
- 3–5 years of experience in medical billing
- 1–3 years of team leadership or supervisory experience
- Bachelor's degree in healthcare administration, finance, or business preferred
Benefits
- Free Continuing Education Units (CEUs) to support licensure and career advancement.
- Competitive Benefits & Perks: Including an employee referral program where you can earn rewards.
- Flexible Scheduling: Enjoy a schedule that aligns with your personal priorities.
Company Overview
Pinnacle Home Care is a full service Medicare Certified and Home Health Company locally owned and operated by home health professionals. It was founded in 2003, and is headquartered in Oldsmar, Florida, USA, with a workforce of 1001-5000 employees. Its website is https://www.pinnaclehomecare.net/.