home health billing specialist

Tampa General Hospital

<div><div>Pharmacy Billing Specialist - Outpatient Specialty - (260001CE)<div>
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Description<div></div> 
The Pharmacy Billing Specialist handles all medication billing functions within Pharmacy Services. Responsibilities include verifying insurance eligibility, facilitating prior authorizations, and collaborating with third-party payers and clinical offices. The specialist works with patients and providers to ensure access to medications and assists with denial appeals and financial assistance through funding sources. Additionally, the role involves auditing hospital pharmacy billing, resolving claim rejections, and supporting medical bill audits. The specialist performs duties in alignment with TGH&rsquo;s mission, vision, and values.<div> 
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Qualifications<div>
</div><ul><li>
Associate's Degree Relevant Field</li><li>
Registered Pharmacy Technician</li><li>
Two (2) years of experience in healthcare, retail, pharmacy, or billing. Experience may be considered in 
lieu of degree.</li></ul><div>
</div></div><div>
Primary Location: Tampa</div><div>
Work Locations: TGH Main Campus 1 Tampa General Circle Tampa 33601</div><div>
Eligible for Remote Work: Hybrid Remote</div><div>
Job: Pharmacy</div><div>
Organization: Florida Health Sciences Center Tampa General Hospital</div><div>
Schedule: Full-time</div><div>
Scheduled Days: Monday, Tuesday, Wednesday, Thursday, Friday</div><div>
Shift: Day Job</div><div>
Job Type: Hybrid Remote</div><div>
Shift Hours: Day shifts 8am to 4:30pm Monday to Friday</div><div>
Minimum Salary: 43,180.80</div><div>
Job Posting: Mar 31, 2026, 9:15:20 AM</div></div>

Pharmacy Billing Specialist - Outpatient Specialty

Kinnic Falls Alcohol-Drug Abuse Services, Inc.

Outpatient Billing Specialist &ndash; Substance Use Disorder (SUD) and Mental Health FacilityPosition SummaryThe Outpatient Billing Specialist for a Substance Use Disorder (SUD) and mental health facility plays a crucial role in the financial health of the organization by overseeing and executing billing processes specific to outpatient SUD and mental health services. This position is responsible for scheduling appointments, preparing and submitting claims, resolving billing issues, and ensuring that billing practices align with regulatory requirements unique to behavioral health and substance use treatment. The specialist works closely with clinical teams, patients, and payers to maximize reimbursement, maintain compliance, and support the mission of the facility.Key Responsibilities&middot; Prepare, review, and submit claims for outpatient SUD and mental health services to insurance companies and third-party payers, ensuring accuracy and completeness with attention to behavioral health codes and regulations.&middot; Verify patient insurance eligibility, benefits, and coverage for SUD and mental health services prior to treatment.&middot; Resolve claim denials, rejections, and discrepancies by communicating with insurers, patients, providers, and behavioral health case managers.&middot; Post payments, adjustments, and denials to patient accounts, ensuring proper allocation of funds as per behavioral health billing standards.&middot; Maintain comprehensive documentation of billing activities, correspondence, and compliance for audit purposes, especially regarding state and federal SUD and mental health regulations.&middot; Respond to patient billing inquiries and explain charges, payments, and insurance coverage relevant to SUD and mental health treatments in a clear and empathetic manner.&middot; Monitor accounts receivable and follow up on unpaid or underpaid claims, focusing on timely reimbursement for substance use disorder services.&middot; Stay current with payer policies, coding guidelines (including CPT, ICD-10, and behavioral health codes), and regulatory changes affecting SUD and mental health billing practices.&middot; Assist the finance department with reconciliation and reporting related to SUD and mental health programs and outpatient services.&middot; Other administrative tasks as assigned.Qualifications&middot; High school diploma or equivalent required; associate degree or certification in medical billing or behavioral health billing preferred.&middot; Minimum of 2 years&rsquo; experience in medical billing, with direct experience in outpatient substance use disorder or mental health services strongly preferred.&middot; Working knowledge of healthcare billing systems, behavioral health insurance plans, and terminology related to SUD and outpatient mental health care.&middot; Solid understanding of CPT, ICD-10, and behavioral health-specific coding, as well as HIPAA and confidentiality requirements for SUD and mental health treatment.&middot; Strong organizational skills and attention to detail.&middot; Ability to communicate compassionately and effectively with patients, providers, and payer representatives.&middot; Proficiency in Microsoft Office and electronic health record (EHR) systems, preferably those used in behavioral health settings.&middot; Experience with obtaining health plan contracts and credentialing providers a plus.Work Environment and Work Hours&middot; Must be present in the office.&middot; 24 hours per week. Afternoon hours. Schedule to be mutually agreed upon.Competencies:<ul><li>Problem Solving--Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.</li><li>Project Management--Develops project plans; Coordinates projects; Communicates changes and progress; Completes projects on time and budget; Manages project team activities.</li><li>Technical Skills--Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.</li><li>Customer Service--Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.</li><li>Interpersonal Skills--Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.</li><li>Oral Communication--Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.</li><li>Written Communication--Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.</li><li>Teamwork--Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.</li><li>Organizational Support--Follows policies and procedures; Completes administrative tasks correctly and on time; Supports organization's goals and values; Benefits organization through outside activities; Supports affirmative action and respects diversity.</li><li>Attendance/Punctuality--Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time.</li></ul>Physical Demands:<ul><li>Occasionally required to stand</li><li>Continually required to walk</li><li>Continually required to sit</li><li>Continually required to utilize hand and finger dexterity</li><li>Occasionally required to climb, balance, bend, stoop, kneel or crawl</li><li>Continually required to talk or hear</li><li>Continually utilizes visual acuity to operate equipment, read</li><li>technical information, and/or use a keyboard</li><li>Occasionally required to lift/push/carry items less than 25 pounds</li><li>Continual exposure to bloodborne and airborne pathogens or infectious materials</li><li>Specialized equipment: all office equipment</li></ul>To apply for this position, please email resume to kmatzek@kinnicfalls.org. Closing date: March 31, 2026Pay: $24.50 - $28.43 per hourWork Location: In person

Outpatient Billing Specialist - Substance Use Disorder and Mental Health Facility

St. Paul's Senior Living Community

About the Role: We are seeking a detail-oriented Nursing Care Billing Specialist to manage end-to-end resident billing and accounts receivable functions for our on-site skilled nursing facility. This role covers Medicare, Medicaid (Medical Assistance), Medicare Advantage/Managed Care, commercial insurance, Long-Term Care insurance, and private pay. You will use MatrixCare as the primary electronic health record (EHR) and billing platform, ensuring accurate claim submission, timely collections, regulatory compliance, and seamless coordination with clinical, admissions, and finance teams.Key Responsibilities:Revenue Cycle &amp; Claims Management<ul><li>Prepare, submit, and monitor skilled nursing home claims for:</li><li>Medicare Part A and Part B</li><li>Medicare Advantage (MA) / Managed Care Organizations (MCOs)</li><li>Medicaid (Medical Assistance)</li><li>Commercial and supplemental insurance</li><li>Long-Term Care insurance</li><li>Private pay residents</li><li>Generate, review, and submit claims using MatrixCare billing and financial modules, clearinghouses, and payer portals in compliance with CMS and payer-specific requirements.</li><li>Validate resident, payer, and charge data within MatrixCare prior to claim submission to ensure billing accuracy and compliance.</li><li>Track claim status, resolve rejections and denials, submit corrected claims, and complete appeals with appropriate clinical and financial documentation.</li><li>Ensure accurate coordination of benefits (COB) and secondary payer billing within MatrixCare and payer systems.</li></ul>Admissions, Eligibility &amp; Authorizations<ul><li>Review admissions, discharges, payer changes, and level-of-care/status changes daily using MatrixCare census and payer reports.</li><li>Verify Medicare Part A skilled coverage eligibility, available benefit days, and benefit exhaustion dates at admission and throughout the stay.</li><li>Obtain, document, and maintain all required prior authorizations, continued stay reviews, and eligibility verifications for Medicare Advantage, Medicaid, and managed care plans.</li><li>Enter benefit, authorization, and coverage notes into MatrixCare for interdisciplinary visibility.</li><li>Participate in interdisciplinary admissions, Medicare, and managed care meetings to remain current on resident coverage and care status.</li><li>Maintain and distribute accurate daily census and payer mix reports to internal departments and contracted service providers as required.</li></ul>Medicaid (Medical Assistance) Billing &amp; Compliance<ul><li>Prepare and submit Medicaid (Medical Assistance) claims and supporting documentation in accordance with federal and state regulations.</li><li>Maintain organized and current Medicaid eligibility records, including benefit cards, authorization notices, and required forms, with appropriate tracking in MatrixCare.</li><li>Notify the County Assistance Office (CAO) or applicable agency of income, asset, or status changes impacting eligibility.</li><li>Monitor pending Medicaid applications and communicate status updates to admissions, social services, and finance teams.</li><li>Prepare for and support Medicaid utilization reviews, eligibility audits, and third-party oversight (e.g., UMR), ensuring MatrixCare records and supporting documentation are complete and audit-ready.</li></ul>Private Pay &amp; Resident Financial Accounts<ul><li>Generate and distribute private pay statements from MatrixCare in accordance with established billing cycles and timelines.</li><li>Respond professionally and promptly to billing inquiries from residents and responsible parties.</li><li>Process refunds, adjustments, and rate changes accurately within MatrixCare.</li><li>Manage resident trust/personal allowance accounts when acting as representative payee, including required reporting for Social Security and Railroad Retirement benefits.</li></ul>Cash Posting, Reconciliation &amp; Reporting<ul><li>Post and reconcile cash receipts, electronic remittance advices (ERAs), and explanation of benefits (EOBs) to resident accounts in MatrixCare.</li><li>Reconcile payer remittances, billing logs, and CMS reports (including PS&amp;R) to ensure accuracy and identify discrepancies.</li><li>Prepare and submit required regulatory reports, including the Medicare Credit Balance Report.</li><li>Maintain accurate accounts receivable aging and supporting documentation using MatrixCare reporting tools.</li></ul>Collections &amp; Write-Offs<ul><li>Monitor outstanding balances using MatrixCare aging and AR reports and initiate follow-up actions in accordance with organizational collection policies.</li><li>Communicate unresolved balances, financial risks, and recommended actions to the CFO or Finance leadership.</li><li>Coordinate with CFO and legal counsel when necessary and maintain documentation for approved write-offs in accordance with internal controls and regulatory timelines.</li></ul>Accounts Payable &amp; Ancillary Coordination<ul><li>Review and approve resident-related ancillary invoices (pharmacy, therapy, labs, insurance premiums, physician services) for accounts payable processing when permitted.</li><li>Reconcile therapy and ancillary billing with departmental and MatrixCare records prior to approval.</li></ul>Compliance, Training &amp; Cross-Coverage<ul><li>Remain current on CMS guidance, Medicaid bulletins, managed care requirements, and MatrixCare system updates affecting billing and reimbursement.</li><li>Participate in ongoing education and training related to billing, compliance, reimbursement changes, and MatrixCare functionality.</li><li>Maintain strict confidentiality and comply with HIPAA and organizational privacy standards.</li><li>Cross-train and provide coverage for other billing functions as needed.</li></ul>Qualifications<ul><li>High school diploma or equivalent required; associate degree in business, accounting, or healthcare administration preferred.</li><li>Minimum five years of experience in healthcare billing, including Medicare, Medicaid, and managed care.</li><li>Experience with MatrixCare or comparable SNF EHR/billing systems strongly preferred.</li><li>Working knowledge of CMS billing rules, PDPM, managed care authorization processes, and coordination of benefits.</li><li>Strong analytical, organizational, and communication skills.</li><li>Ability to work independently, manage competing priorities, and meet regulatory deadlines.</li><li>Experience with Microsoft Office Suite.</li></ul>Pay: $25.00 per hourBenefits:<ul><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible spending account</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Referral program</li><li>Vision insurance</li></ul>Work Location: In person

Nursing Care Billing Specialist

University of Texas Medical Branch

<div>EDUCATION &amp; EXPERIENCE:
Minimum Qualifications:<ul><li>
Two years of financial experience or one year of patient accounts experience.
</li></ul>JOB SUMMARY:
The Patient Account Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or hospital claims. Identifies billing issues affecting hospital and/or physicians claims/accounts and takes necessary action to ensure timely and appropriate claim filing. Performs follow-up activities and identifies reimbursement issues affecting these claims. Takes necessary actions to ensure timely and appropriate reimbursement and account resolution.
ESSENTIAL JOB FUNCTIONS:<ul><li>
Demonstrates a level of competence and understanding of all state and federal laws, rules, and regulations regarding payer billing guidelines</li><li>
Demonstrates a basic understanding of CPT, ICD-9, HCPCS, modifier coding as well as POS requirements</li><li>
Billing payers and/or clients for hospital and/or Professional Patient Accounts</li><li>
Resolves Payer rejections from billing system daily to bill submit hospital and/or physicians claims</li><li>
Performs online corrections to edited claims according to procedures</li><li>
Performs detailed follow-up activities on assigned accounts according to procedures</li><li>
Responds to daily correspondence according to procedures</li><li>
Identifies denials and underpayments for appeal</li><li>
Reviews, researches, and processes denied claims</li><li>
Appeal claims as appropriate according to policies and procedures</li><li>
Updates account information and documents as appropriate within Epic Resolute</li><li>
Processes account adjustments according to policies/procedures</li><li>
Issues payer and/or patient refunds according to policies/procedures</li><li>
Validates accuracy of payments and/or adjustments on accounts</li><li>
Resolves outstanding accounts at required accuracy and productivity requirements</li><li>
Maintains comprehensive knowledge of the work unit assigned</li><li>
Assists in the development of department policies and procedures</li><li>
Adheres to established policies and procedures</li><li>
Adheres to internal controls and reporting structure</li><li>
Maintains open and professional communication with customers, colleagues, and vendors</li><li>
Performs well in a team environment</li></ul>
Marginal or Periodic Functions:<ul><li>
Successfully completes competency-based training and testing</li><li>
Prioritizes and completes all work in an accurate, effective, and efficient manner</li><li>
Participates in team meetings/activities and supports the philosophy and goals of the team and department</li><li>
Assists in the training and mentoring of new employees</li><li>
Reads all announcements and relevant communications relating to job duties</li><li>
Performs related duties as required.</li></ul>
WORKING ENVIRONMENT/EQUIPMENT:<ul><li>
Standard hospital, clinical, laboratory and/or office environments.</li><li>
Standard office equipment.</li></ul>
SALARY RANGE:
Actual salary commensurate with experience.
WORK SCHEDULE:
On-site, Monday through Friday, 8 AM - 5 PM. 
Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.</div>

Patient Account Specialist - Revenue Cycle HB Billing & Denials

way above aba

Job Description:We are a fast-growing healthcare services company offering end-to-end solutions for agencies &mdash; from startup to expansion and operations.Our services include: Agency buying &amp; selling transactions Healthcare licensing (Home Care, ABA, Telehealth, Hospice, etc.) Contracting &amp; credentialing with insurance payers Full-service medical billingWe are looking for a highly reliable and experienced professional who understands the healthcare backend and can also drive sales and client acquisition.Responsibilities:Handle inbound &amp; outbound sales calls with healthcare providersUnderstand client needs and present tailored service solutionsClose deals and bring in new businessMaintain strong relationships with clientsSupport or oversee medical billing / credentialing processes when neededWork closely with our internal team to ensure smooth onboardingRequirements:Strong experience in medical billing and/or credentialingSales experience (closing deals, handling objections, client communication)Excellent English communication skillsHighly reliable, organized, and self-motivatedAbility to work fully remote and manage your own scheduleKnowledge of healthcare agency operations is a big plusCompensation:Base pay + high commission potentialPerformance-based bonusesLong-term growth opportunityWhy Join Us:Work with a company that handles everything from startup to scalingHigh demand services with strong earning potentialFlexible remote work environmentPay: $15.00 - $25.00 per hourWork Location: Remote

Healthcare Sales & Billing Specialist (Remote) – Licensing, Credentialing & Medical Billing

Advanced Home Health

Do you enjoy using your multi-tasking and organization skills?Do you find satisfaction in having foresight and strategies to ensure your plan and message makes a great impact?Advanced Home Health is seeking an outstanding Medicare Billing Specialist to join our Transitional Care Unit (TCU) team. This is a Full-time on-site and in person position working out of our head office in Idaho Falls, ID. This is a great opportunity to take your career to the next level. Apply today to learn more about this position and the great benefits that come with being an employee at Advanced Home Health!*Applicants must have at least one year of experience in Medicare Billing, preferably in a Post-Acute Rehabilitation, Transitional Care Unit, or Skilled Nursing Facility. *Advanced Home Health Believes That Our Employees Are Our Greatest Asset<ul><li>Get paid more with us! Competitive wages per industry average for similar positions in the area.</li><li>Be part of a team and company that that believes in leading with our values.</li><li>Professionally develop your skills with in-service training to ensure most up to date in accordance with state and federal practices.</li><li>Be recognized and rewarded for your compassion, excellence, and reliability.</li><li>Perks for Full-Time include Professional Development Assistance, 401(k), Health insurance, Dental insurance, Vision insurance, Life insurance, Paid time off and more!</li></ul>Summary of ResponsibilitiesThe Medical Billing Specialist main task will be to communicate with insurance companies to advocate on behalf of our patients to ensure they are getting the care they need. Claims must be accurate and timely completed and submitted to the patient specific insurance company or private payer billing, as well as accounts receivable tracking and follow-up. Knowledge of healthcare processes and healthcare jargon is important for effective communication and is recommended for this position. Our team ensures that all staff are quickly recognized as an integral part of the team and help make a positive lasting impression with our community.Qualifications<ul><li>High school graduate or equivalent.</li><li>Two (2) years of experience in health care data entry in healthcare/ home health preferred.</li><li>One (1) year of Medicare billing experience in healthcare/ home health preferred.</li><li>Experience with Medicare FISS/DDE system.</li><li>Able to use IBM-compatible systems and be proficient in Microsoft Office.</li><li>Communication skills to converse clearly over the telephone and in person.</li><li>Organization and time management to manage a variety of tasks effectively.</li><li>License driver with well working automobile for reliability getting to and from work in all types of weather.</li></ul>Advanced Home Health is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, or any other characteristic protected by law.Job Type: Full-timeBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Application Question(s):<ul><li>This is a full-time, on-site position and is not eligible for remote work. Is that what you are looking for?</li><li>Please confirm the best phone number and email address to reach you to discuss the next steps. </li><li>How many years of medical billing experience do you have in Post-Acute Rehabilitation, Transitional Care Unit, or Skilled Nursing Facility?</li></ul>Experience:<ul><li>Medical billing: 1 year (Required)</li></ul>Work Location: In person

Billing Specialist

Aegis Health Services

<div>
 
 
 Company Description
 
 
 
 Aegis Health Services is dedicated to driving better patient outcomes through population health management. The organization focuses on improving healthcare delivery by ensuring that patients receive coordinated and comprehensive care. With a strong emphasis on quality, Aegis Health Services strives to create impactful and sustainable solutions in the healthcare industry.
 
 
 
 
 
 
 Role Description
 
 
 
 This is a full-time hybrid role for a Medical Billing Specialist based in Sandy Springs, GA, with the flexibility to work partially from home. We are looking for an organized and experienced medical billing specialist. The medical billing specialist will be responsible for multiple aspects of the revenue cycle and must be able to multitask, prioritize, and manage time efficiently.
 
 
 
 
 
 Duties will include but are not limited to:
 
 
 
 
 <ul>
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 Reviewing daily charges for accuracy by verifying patient and payor information on all patients and claims.
 </li>
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 Performing insurance verification and eligibility checks.
 </li>
 <li>
 Resolving payer specific and clearinghouse claim errors and rejections.
 </li>
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 Correcting and submitting claims to insurance companies.
 </li>
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 Working aged account receivables.
 </li>
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 Analyzing insurance remittances for posting payments and denials.
 </li>
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 Submitting required documentation for reimbursement.
 </li>
 </ul>
 
 
 
 
 
 Qualifications
 
 
 <ul>
 <li>
 3+ year of medical billing and coding
 </li>
 <li>
 Ability to verify patient benefits, analyze EOBs, determine appropriate codes for procedures performed, and post payments.
 </li>
 <li>
 Knowledge of CPT, HCPCS, and ICD-10 coding.
 </li>
 <li>
 Knowledge of Medicare, Medicaid, and other commercial health plans.
 </li>
 <li>
 Knowledge of EHR systems, spreadsheets, and word documents.
 </li>
 <li>
 Ability to work independently and manage multiple priorities.
 </li>
 <li>
 Ability to prioritize, organize, and exercise independent judgement and maintain confidentiality.
 </li>
 <li>
 Excellent analytical, verbal, and written communication skills.
 </li>
 </ul>
 
 
 
 
 **Salary compensation is based on experience**
 
 
 
 $24.00 - $28.00 per hour
 
 
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Medical Billing Specialist

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