Reimbursement Specialist – Home Health Exp Preferred

Addus HomeCare

. Investigate insurance benefits for new referrals .

Posted 10/9/2026full-timeRemote • Texas • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in healthcare collections and billing, with a strong understanding of hospice billing regulations, including Medicare and Medicaid. Proficient in claim resolution, payer communication, and maintaining compliance with HIPAA regulations.

Highest-signal resume keywords

Healthcare Collections ExperienceHospice Billing RegulationsClaim Resolution SkillsEOB InterpretationCustomer Service Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Healthcare BillingClaims SubmissionInsurance VerificationAlphanumeric Data EntryAR Reports ManagementRoot-Cause AnalysisDenial ManagementPayer Follow-UpQuality ImprovementCompliance Review

Soft Skills

Effective CommunicationOrganizational SkillsSelf-StarterTeam CollaborationAttention to Detail

Tools & Technologies

MS OfficeWeb-Enabled Applications

Industry Keywords

MedicareMedicaidHIPAAEOBsRemittancesDenial CodesPayer RepresentativesHealthcare RegulationsFinancial Burden SolutionsContinuous Quality Improvement

About the role

Key responsibilities & impact

Investigate insurance benefits for new referrals
Assign and pursue collections with a variety of payers
Request authorizations and submit claims
Interpret patient insurance, prescription, and other health-related documentation
Conduct medical insurance verifications and investigations for commercial and government payors
Communicate with insurance companies, patients, providers, and prescribers to coordinate reimbursement and access solutions
Review unpaid accounts, determine status, and take appropriate action to ensure payment
Review claims for compliance and completeness before submission
Research alternative funding options to reduce patients’ financial burden
Handle high call volumes
Coordinate care with internal and external departments
Maintain confidentiality of sensitive information
Maintain regular, predictable, consistent attendance and flexibility to meet department needs
Follow applicable regulations, policies, procedures, and standards
Participate in continuous quality improvement
Perform other duties as assigned

Requirements

What you’ll need

High school diploma or equivalent is required
Undergraduate degree is preferred
5 years of healthcare collections/billing experience preferred
Strong understanding of hospice billing regulations (Medicare, Medicaid, commercial)
Ability to read and interpret EOBs, remittances, and denial codes
Effective payer follow-up and escalation strategies
Ability to resolve claim holds, rejections, and denials
Ability to identify trends in denials or delays
Root-cause analysis to prevent recurring issues
High attention to detail to ensure clean claims
Ability to work AR reports and aging summaries accurately
Clear, professional communication with internal teams and payer representatives
Ability to explain payer issues in plain, understandable language
Quick and accurate alphanumeric data entry skills
Computer proficiency; MS Office and web-enabled applications strongly preferred
Customer service skills required
Ability to plan and organize work effectively and ensure completion
Ability to meet productivity requirements
Self-starter with exceptional organizational and follow-through skills
Ability to work independently and in a team environment
Must follow Medicare, Medicaid, and HIPAA regulations and requirements

Benefits

Comp & perks

Medical, Dental and Vision Benefits
Continued Education
PTO Plan
Retirement Planning
Life Insurance
Employee discounts
Remote work schedule