Job description

Join our Team and Make a Difference!

Better Service, Better Quality, Better Results!

• Growth Opportunities as we Continue to Expand
• Fun, Team-Oriented Environment
• We are Committed to You and Your Well-Being
• Learning and Development Opportunities
• Competitive Rates and Excellent Benefits

Advantage is currently seeking a Billing and Reimbursement Manager for our Home Health and Hospice Division. This position will be a hybrid position partially remote with office days as needed. Our Corporate Office is located in Pittsburgh, PA (Baldwin area - very close to South Hills Country Club and Century III Mall). The Billing and Reimbursement Manager will oversee a team of reimbursement/billing specialists and is responsible for understanding all aspects of the billing process. This position will ensure claims are being processed in a timely manner and follow-up is completed on claim denials. Must have both Home Health and Hospice billing experience. Previous Management experience required.

Essential Duties and Responsibilities:

• Leads employees in all aspects of the revenue cycle.
• Ensures staff is properly directed to achieve the greatest reimbursement legally possible for the practice.
• Establish and regularly measure through reporting on key performance indicators for the department including but not limited to: accounts receivable, cash collections. Denials as a percent of net revenue, percentage of clean claims, controllable write-offs, etc.
• Accountable to ensure that the department is up to date with current rules and regulations of the insurance payors.
• Accountable for all aspects of the department including but not limited to: interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and coaching employees; addressing complaints and resolving problems.
• Possess complete understanding of the billing/collection process to resolve complex, outstanding claims.
• Ensures accounts are billed accurately and timely by providing proactive oversight and direction for billing and collections.
• Maintains current knowledge of healthcare billing systems and government payer systems, including applicable federal/state laws and regulations, as well as all aspects of third-party reimbursement policies and practices
• Demonstrates ability to supervise, train and motivate employees, as well as a professional attitude in relating to executive management, professionals, and third-party insurance carriers.
• Organizes and leads efforts to maximize operational efficiency and optimize reimbursement, as well as monitors denials and provides education and reporting to the areas regarding the effect of denials from their areas.
• Reviews payor contracts and credentialing
• Reviews all statistical reports to monitor trends, determine operational deficiencies and implement corrective action plans as necessary
• Manages and assures timely submittal of claims through effective supervision of staff
• All other duties as assigned

Qualifications:

• HS Diploma required. Secondary education preferred.
• 2-3 yrs. of Medical Billing Management or equivalent experience required
• Knowledge and understanding of billing regulations
• Familiar with Billing Software, payor contracts and credentialing
• Proficiency with Microsoft Office and Strong Organizational and Time Management skills
• Both Home Health and Hospice Billing Experience Required
• Management Experience Required

Advantage offers:

• Competitive Compensation Package
• Top Rated Benefits including Medical, Dental, Vision and Prescription Coverage
• Company Paid Long Term Disability
• Paid time off
• 401(k) with Company Match
• Flexible Spending Account
• Life Insurance
• Opportunities for Career Advancement

About ADVANTAGE:

Advantage is a high-growth provider of essential rehabilitation and medical services to seniors spanning the post-acute care continuum. Advantage provides contract rehabilitation services to seniors in skilled nursing facilities and provides home health and hospice services to seniors living in their homes. The Company is a market leader in Pennsylvania where it seeks to further expand its market share as well as rapidly scale in adjacent geographies. Advantage is Founder-led and is investing heavily in its senior leadership team and infrastructure to support its long-term growth objectives. Underpinning the Company’s market position and growth aspirations is its “patient-first” corporate culture and commitment to superior clinical outcomes. The Company’s [600+] clinicians are committed to the Advantage motto “You Deserve to Get Better: Better Service, Better Quality and Better Results.” Whether you are a patient, an employee or a customer, our mission is to ensure “You Deserve to Get Better.”

Job Type: Full-time

Benefits:

• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Ability to commute/relocate:

• Pittsburgh, PA 15236: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Hospice Billing: 1 year (Required)
• Home Health Billing: 1 year (Required)

Work Location: One location

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