Home Health Revenue Cycle Specialist

Job DetailsJob Location First Senior Home Health IV - Orange Park, FL Description Position Summary The Revenue Cycle Specialist is responsible for managing all aspects of the home health agency's billing, collections, accounts receivable, and revenue reconciliation processes. This position ensures timely, accurate claim submission and optimal reimbursement by collaborating closely with clinical leadership, financial leadership, and operational teams. The specialist identifies and resolves issues preventing billing, monitors aging and payment trends, and provides monthly reporting to support informed financial decision-making across all agency offices. Essential Duties and Responsibilities: Billing & Claims Management Prepare, review, and submit all Medicare, Managed Care, and Commercial insurance claims in accordance with regulatory and payer requirements. Perform detailed claim audits to ensure accuracy, completeness, and compliance prior to submission. Identify and resolve claim edit failures, clinical documentation delays, authorization barriers, or missing information that prevents successful billing. Coordinate proactively with clinical leadership, branch directors, and financial leadership to address issues impacting timely claim submission. Accounts Receivable (AR) Follow-Up Monitor and manage the aging of accounts receivable across all payers and office locations. Conduct timely follow-up on unpaid or underpaid claims to reduce AR days and minimize write-offs. Communicate with payers, obtain claim status, research denials, and take corrective action to ensure reimbursement. Track payer trends and escalate systemic issues affecting AR performance. Payment Posting & Reconciliation Accurately post all payments, adjustments, and remittances into the EMR. Reconcile daily, weekly, and monthly cash postings. Perform month-end reconciliation of billed revenue, payments received, outstanding AR, and adjustments. Assist with month-end close to ensure financial accuracy and compliance. Reporting & Analytics Prepare and distribute monthly financial dashboards for each office, highlighting: Revenue billed Payments received AR aging Unbilled revenue Denial rates Outstanding issues preventing billing Present financial data in a clear, actionable format to leadership. Identify performance opportunities and propose solutions to improve cash flow and reduce AR days. Collaboration & Communication Work closely with clinical managers, schedulers, quality team, intake, and operations to resolve billing holds related to documentation, orders, authorizations, or visit completion. Partner with financial leadership to analyze trends, support audits, and ensure adherence to agency financial policies. Maintain a high level of professionalism and timely communication across all departments. Compliance & Documentation Integrity Ensure all billing practices comply with Medicare Conditions of Participation, payer guidelines, and agency policies. Maintain accurate, organized financial and billing records. Support internal and external audits by providing necessary documentation and reports. Qualifications Qualifications Education & Experience High school diploma required; Associate's or Bachelor's in Healthcare Administration, Accounting, Business, or related field preferred. Relevant experience may substitute for required education on a year-for-year basis. Minimum 3-5 years of home health revenue cycle, billing, or AR experience required. Strong working knowledge of Medicare home health billing, OASIS requirements, PDGM, and payer regulations. Skills & Competencies Proficiency with home health EMR/billing systems Excellent understanding of EOBs, RAs, payer portals, and electronic claim submission processes. Strong analytical, mathematical, and problem-solving skills. Ability to manage multiple tasks and deadlines in a fast-paced environment. Excellent communication and interpersonal skills. High attention to detail, accuracy, and follow-through. Physical Requirements Ability to sit for extended periods. Ability to work independently and with minimal supervision. Standard office environment with routine use of computer and office equipment. Working Conditions Monday-Friday schedule with flexibility based on workload. Remote Occasional travel to attend management meetings may be required.