Home Health & Hospice Revenue Cycle Associate at NORTHERN COUNTIES HEALTH CARE INC – St.Johnsbury, Vermont

Job Summary:

The Home Health & Hospice Revenue Cycle Associate serves as the primary point of contact between the Home Health & Hospice team and the organization's outsourced billing company. This position is responsible for ensuring accurate, timely, and complete communication and coordination of billing-related information and documentation. The RCA helps support the revenue cycle process by facilitating claims resolution, responding to billing inquiries, monitoring denials and reimbursements, and ensuring compliance with payer requirements.

Supervisory Responsibilities:

This position has no direct supervisory responsibilities.

Essential Job Functions/Responsibilities:

• Serves as the internal liaison between clinical staff, administrative staff, and the outsourced billing company.
• Tracks the status of outstanding claims, denials, and re-submissions in coordination with the billing company.
• Responds to requests for information from the billing company in a timely and accurate manner.
• Identifies and escalates billing issues or trends that may impact reimbursement or compliance.
• Assists with monitoring accounts receivable reports and follow up on unpaid claims as needed.
• Supports the intake and authorization process by confirming payer requirements and verifying insurance.
• Manages all aspects of Medicare Advocacy Project and Children’s Integrated Services billing and accounts receivable.
• Maintains organized and compliant billing-related records and documentation.
• Collaborates with clinical and administrative staff to ensure documentation completeness and accuracy for billing purposes.
• Participates in internal audits and provides support during external audits or reviews related to billing practices.
• Stays informed of relevant payer guidelines and regulatory changes affecting home health and hospice billing.
• Researches, collects and logs advanced directives for all clients.

The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Position Qualifications:

• High school diploma or equivalent required; Associate’s degree or healthcare billing certification preferred.
• Minimum of 2 years of experience in medical billing, preferably in home health and/or hospice.
• Working knowledge of Medicare, Medicaid, and commercial insurance billing practices.
• Proficiency in electronic medical records (EMR) and Microsoft Office Suite.
• Strong attention to detail and organizational skills.
• Excellent communication and interpersonal skills.
• Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
• Must maintain a high level of confidentiality.
• Requires prolonged sitting, some bending, stooping and stretching.
• Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photo-copier, telephone, calculator and other office equipment.
• Requires normal range of hearing and eyesight to record, prepare, and communicate appropriately.
• May occasionally be in a position to lift and/or carry an item weighing up to 25 pounds.