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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing and claims submission, particularly for Medicare, Medicaid, and commercial insurance, with a strong focus on Home Health and Hospice services. Proficient in utilizing Electronic Medical Records (EMR) and billing systems to ensure compliance and accuracy in claims processing.
Highest-signal resume keywords
Medical Billing ExperienceClaims Submission to Medicare and MedicaidElectronic Medical Record (EMR) ProficiencyRevenue Code Knowledge for Home Health and HospiceAttention to Detail
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims SubmissionRevenue Code ApplicationPre-Billing AuditsPayment PostingReconciliation
Soft Skills
Organizational SkillsAnalytical SkillsProactive Problem SolvingPersistence
Tools & Technologies
Billing SystemClearinghouses
Industry Keywords
Home Health BillingHospice BillingPDGM ComplianceFederal and State Regulations
About the role
Key responsibilities & impact- Prepare, review, and accurately submit institutional claims (e.g., UB-04s/CMS-1450s) to Medicare, Medicaid, and commercial insurance carriers via electronic submission
- Ensure the correct use of revenue codes on all claims to comply with payer requirements and minimize claim rejections
- Work closely with the Collections team or perform initial follow-up on delayed, short-paid, or denied accounts, providing documentation to facilitate recovery
- Conduct pre-billing audits to verify patient eligibility, authorization validity, and complete documentation before claim submission
- Stay current on federal and state regulations, including PDGM for Home Health and Hospice payment rates, ensuring claims reflect the latest changes
Requirements
What you’ll need- Minimum of 1 year of dedicated experience in medical billing and claims submission, with a strong preference for experience in Home Health or Hospice billing
- Proven ability to submit and manage claims to Medicare, Medicaid, and commercial insurance
- Proficiency in navigating an Electronic Medical Record (EMR) and billing system and utilizing clearinghouses for electronic claim submission
- Solid working knowledge of revenue codes related to home health and hospice services
- Exceptional attention to detail and commitment to 100% claim accuracy
- Strong analytical and mathematical skills for reconciliation and payment posting
- Excellent organizational skills and the ability to manage high-volume submission deadlines
- Proactive and persistent approach to resolving billing edits and rejections
- Strong ethical commitment to compliance and accurate financial reporting
