This Revenue Cycle Specialist role supports billing operations by processing Government and Commercial claims in a timely manner. The position is crucial for maintaining accurate medical records, identifying payer trends, and ensuring billing compliance throughout the revenue cycle. It suits a detail-oriented and highly organized candidate with experience in home health or hospice billing and a strong understanding of payer systems and reimbursement processes.
Responsibilities
Process assigned Medicare, Medicaid, and/or Commercial claims and payments accurately and within payer timelines
Track daily documentation for physician orders and signatures
Notify administration of missing documents and maintain patient medical records
Maintain required logs, rosters, and documentation records
Identify payer behavior trends and report unexpected patterns to the Revenue Cycle Manager
Participate in quality improvement activities related to billing performance
Communicate professionally with field staff regarding documentation and unbilled revenue
Follow up on outstanding billing items and understand clearinghouse edits and electronic billing rejections
Review and interpret Explanation of Benefits (EOBs) to determine next steps in payment posting or appeals
Requirements
Excellent troubleshooting and problem-solving skills
Strong understanding of revenue cycle operations and medical billing workflows
Comfortable managing a high volume of claims in a metrics-driven environment
Ability to work with confidential data and maintain accuracy in data entry
Capable of working independently and collaborating with cross-functional teams
Skilled at using multiple computer applications and clearinghouse platforms
Familiarity with payer guidelines, filing limits, and billing edits
Strong verbal and written communication skills for engaging with clinical staff
Flexible and responsive to departmental and organizational needs
Must be at least 18 years old with a high school diploma or GED
Minimum of 2 years of experience in Home Health or Hospice billing required
Advanced Microsoft Office skills, including basic to advanced Excel capabilities
Nice to have:
Experience with Homecare HomeBase
Experience with billing tools such as DDE, E-solutions, Waystar, and/or Nthrive
Benefits
401(k) with Company Match
Career Advancement Opportunities
National & Local Recognition Programs
Teammate Assistance Fund
Millions of jobs, with real people getting hired every day
Employee must meet minimum requirements to be eligible for benefits
Where applicable, employee must meet state specific requirements
About the Company
Gentiva is a national leader in hospice care, palliative care, home health care, and advanced illness management, with nearly 600 locations and thousands of dedicated clinicians across 38 states. The company offers compassionate care in the comfort of patients' homes, helping people recover from illness, injury, or surgery, and guiding patients and their families through serious or terminal illnesses. Its family of trusted brands includes Gentiva Hospice, Emerald Coast Hospice Care, Heartland Hospice, Hospice Plus, New Century Hospice, Regency SouthernCare, SouthernCare Hospice Services, SouthernCare New Beacon for hospice care; Empatia Palliative Care, Emerald Coast Palliative Care for palliative care; Heartland Home Health for home health care; and Illumia Health for advanced illness management. With corporate headquarters in Atlanta, Georgia, Gentiva offers rewarding careers in a collaborative environment.
