As a SENIOR ACCOUNTS RECEIVABLE SPECIALIST, you will:

• Guides collectors in their performance of invoice processing activities for designated agencies, branch locations, Regional Care Center (RCC) and assigned national contract to ensure receivables are reimbursed in an accurate and timely basis. 
• Works directly with the payer, internal and external customers and other contract clients towards efficient and effective collection results. 
• Works under moderate supervision.
• Abides by and demonstrates the company Mission – Vision – Values through both behavior and job performance on a day-to-day basis.
• Ensures the coordination of invoice activities for designated agencies, locations and assigned regional and national contracts, leading to the timely reimbursement of receivables using available resources including databases, internet, and telephone. 
• Researches and resolves denials received daily which have not passed payer edits, which may lead to a final appeal of denied services. May utilize Unity, HEAT, Client Access (imaging) and payer websites. 
• Determines and initiates action to resolve rejected invoices and prepares payer corrections and/or appeals using electronic and paper processes. Subsequently resolves rejected and/or returned appeals from payer.
• Guides/instructs and supports agencies, branch locations, Regional Care Center(s), National Claims Center (NCC), network providers and regional and national payer personnel encompassing all aspects of insurance, government payers and private pay claims processing.
• Communicates with agencies, branch locations, RCC’s, NCC and National Account Liaisons to educate them concerning the importance of clean claims.
• Utilizes various resources to determine patient’s eligibility, benefits and health plan confirmation. This includes online payer databases, and medical records triggering provider recoup/rejection activity. Communicates with the agencies, branch locations, RCC(s) and NCC as necessary.
• Analyzes and clears payment variances. May prepare adjusted and corrected bills. May adjust accounts receivable entries in accordance with existing operating procedures. This may include the use of special reporting.
• Evaluates, analyzes and monitors the processing of invoices and on-line notes, utilizing a windows-based data processing system.
• Monitors payer responses, and may utilize Microsoft Excel, Microsoft Access and other software as necessary to ensure prompt payment.
• Oversees accounts receivable adjustments to resolve overpayments and payment rejections per standard operating procedures.
• Determines necessary materials to send to the patient, such as coordination of benefit letters, federally mandated OTH letters and Third Party Liability notifications.
• Contact agencies, branch locations and providers of service to retrieve appropriate medical documentation, billing information and/or PPS Oasis forms to substantiate services provided.
• Provide details/itemizations of services performed to our national payers and patients ensuring timely reimbursement.
• Review EOP/EOMB/EOB’s for accuracy of patient responsibility.
• Provides input on accounts receivable plans and process improvement, assisting in their implementation.
• Prepares ad hoc financial reports for up-line management to use in the evaluation of accounts receivable performance.   
• Participates in teleconferences covering a wide range of topics that enables the FSU and NBC to effectively collect accounts receivable. 
• Assist Lead Collector with training of newly-hired associates, as well as re-education of collection teams as necessary.
• Acts as an information resource for hard to collect accounts and as a “grey area” subject matter expert.
• Ensures the coordination of special handling and/or reconciliation spreadsheets for national payers and/or clients.
• Monitors team results to ensure they are aligned with departmental goals.
• Works with internal customers to initiate, test and implement new enhancements or platforms as necessary.
• Assures the completion and coordination of work in an associate’s absence, or as needed to maintain departmental standards.

REQUIRED EXPERIENCE/SKILLS: 

• High School Diploma or the equivalent plus a minimum of three years medical claims processing experience generally required. 
• Knowledge of healthcare collection procedures and microcomputer software/hardware required. 
• Effective analytical and communication skills also required as well as knowledge of HIPAA and the Fair Credit and Collections Act, HCPC, CPT and ICD-9/10 coding, intermediate competency of Microsoft Office Applications and mathematical calculations.
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. 
• The requirements listed below are representative of the knowledge, skill, and/or ability required. 
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• This role requires full COVID-19 vaccination

Required Skills

TOGETHER, WE CAN RAISE THE BAR ON HOME HEALTHCARE

CenterWell™ Home Health (formerly Kindred at Home), is one of the nation’s leading providers of home care, with an incredible team of compassionate clinicians who deliver high-quality, specialty care to patients. Many of our clinicians live in the same neighborhoods they serve – providing the much-needed care to people in their community.

As a company, we strive to lead by example and show employees the same compassion and care we expect them to show patients. We provide employees the resources, stability, and job flexibility they truly deserve. We help them fulfill their personal and professional goals while enjoying industry-leading benefits, competitive salaries, opportunities for career and professional growth, and a healthy work/life balance.

PART OF HUMANA’S HOME SOLUTION BUSINESS

CenterWell Home Health cares for nearly 80,000 patients every day in over 350 locations, across 38 states. As part of Humana Inc., we create experiences that put patients at the center, working in collaboration with healthcare providers to bring multidisciplinary care directly to the comfort and safety of home. The result is easy, comprehensive and personalized care that helps patients lead healthier, happier lives.

CARING FOR PEOPLE WHO CARE FOR OUR PATIENTS

Experience has shown us that supporting and nurturing employees helps them become the best version of themselves and more compassionate, committed home health professionals. That’s why CenterWell Home Health never stops working to improve the employee experience. Our people are our greatest resource, and we are committed to creating an environment they enjoy stepping into every day.

WORLD-CLASS EMPLOYEE BENEFITS

• Competitive pay and benefits package
• 50% matching 401(k) contributions up to 6%
• Career advancement opportunities
• Tuition reimbursement program
• Advanced Continuing Education (CE) accredited training

Required Experience

JOIN OUR TEAM!

Check out our video to get a glimpse of a day in the life of our Home Health team - Home Health

TO LEARN MORE, PLEASE CONTACT YOUR LOCAL RECRUITER AT (TOLL-FREE) 855-563-2846 OR APPLY ONLINE. OUR RECRUITERS ARE READY TO HELP YOU START A NEW AND REWARDING CAREER WITH CENTERWELL HOME HEALTH.

TOGETHER, WE CAN RAISE THE BAR ON HOME HEALTHCARE

CenterWell™ Home Health (formerly Kindred at Home), is one of the nation’s leading providers of home care, with an incredible team of compassionate clinicians who deliver high-quality, specialty care to patients. Many of our clinicians live in the same neighborhoods they serve – providing the much-needed care to people in their community.

As a company, we strive to lead by example and show employees the same compassion and care we expect them to show patients. We provide employees the resources, stability, and job flexibility they truly deserve. We help them fulfill their personal and professional goals while enjoying industry-leading benefits, competitive salaries, opportunities for career and professional growth, and a healthy work/life balance.

PART OF HUMANA’S HOME SOLUTION BUSINESS

CenterWell Home Health cares for nearly 80,000 patients every day in over 350 locations, across 38 states. As part of Humana Inc., we create experiences that put patients at the center, working in collaboration with healthcare providers to bring multidisciplinary care directly to the comfort and safety of home. The result is easy, comprehensive and personalized care that helps patients lead healthier, happier lives.

CARING FOR PEOPLE WHO CARE FOR OUR PATIENTS

Experience has shown us that supporting and nurturing employees helps them become the best version of themselves and more compassionate, committed home health professionals. That’s why CenterWell Home Health never stops working to improve the employee experience. Our people are our greatest resource, and we are committed to creating an environment they enjoy stepping into every day.

WORLD-CLASS EMPLOYEE BENEFITS

• Competitive pay and benefits package
• 50% matching 401(k) contributions up to 6%
• Career advancement opportunities
• Tuition reimbursement program
• Advanced Continuing Education (CE) accredited training