Revenue Cycle Representative - AR

Responsibilities

• Follow up on submitted home health and hospice claims with Medicare, Medicaid, and commercial payers
• Investigate and resolve unpaid, underpaid, or denied claims in a timely manner
• Analyze Explanation of Benefits (EOBs) and remittance advice to identify discrepancies
• Submit claim corrections, rebills, and appeals as needed
• Communicate with payers via phone, portals, and written correspondence to resolve claim issues
• Maintain accurate documentation of all follow-up actions and payer communications
• Work closely with team leads for account resolution
• Monitor AR aging reports and prioritize accounts for follow-up
• Ensure compliance with Medicare, Medicaid, and payer-specific billing guidelines
• Meet productivity and AR resolution benchmarks

Requirements

• Minimum of 2 years experience in AR management, medical billing, or revenue cycle (home health and/or hospice preferred but not mandatory)
• Strong knowledge of Medicare, Medicare Advantage, Medicaid, and commercial payer processes
• Experience with claim follow-up, denials, and appeals
• Familiarity with home health and hospice billing regulations (OASIS, NOA/NOE, PDGM, hospice benefit periods preferred)
• Proficiency with billing software and payer portals
• Strong attention to detail and problem-solving skills
• Excellent communication and documentation skills
• Preferred Skills
• Experience with Medicare replacements and managed care plans
• Understanding of payer authorization and eligibility requirements
• Ability to manage high-volume AR and meet deadlines independently
• Knowledge of compliance and audit readiness standards

Benefits

Additional Information

The AR Management Specialist is responsible for managing and resolving accounts receivable for home health and hospice claims after submission. This role focuses on timely follow-up, denial resolution, payer communication, and ensuring accurate reimbursement in compliance with Medicare, Medicaid, and commercial payer guidelines.

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Company Intel

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