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Billing Audits & Quality Improvement Coordinator - Home Health

Job Description

Division: Home Office

Are you in search of a new career opportunity where you are the connection? If so, now is the time to choose Encompass Health as your employer. The Home Health & Hospice division of Encompass Health is hiring!

 

As a national leader across home health, hospice, and inpatient rehabilitation hospitals, Encompass Health is consistently ranked as a top best-place-to-work in the communities we serve. Our philosophy of delivering a better way to care exemplifies our commitment to quality, compassionate care for our patients, all while fostering a unique culture that is compassionate and collaborative.

  • Encompass Health’s enterprising model of the continuum of care for post-acute services sets the standards for excellence. This is evident throughout all of our care settings and office locations, as we maintain a workplace that is stable, ethical, and supportive.
  • At Encompass Health, we continually invest in employees to assist in them achieving personal goals and make meaningful, measurable differences in the lives of their patients.

Ever-mindful of the need for employees to care for themselves and their families, Encompass Health offers benefits that encourage lifestyle choices that keep you healthy and happy. Subject to employee eligibility, some benefits, tools, and resources include:

  • Generous time off with pay for full-time employees
  • Continuing education opportunities
  • Scholarship program for employees and their children
  • Matching 401(k) plan for all employees
  • Comprehensive insurance plans for medical, dental, and vision coverage for full-time employees
  • Supplemental insurance policies for life, disability, as well as critical illness, hospital indemnity and accident insurance plans for full-time employees
  • Flexible spending account plans for full-time employees
  • Minimum essential coverage health insurance plan for all employees
  • Electronic medical records & mobile devices for all clinicians
  • Incentivized bonus plan

Responsibilities

The audits and quality improvement (QI) coordinator is responsible for the end of episode billing and reimbursement functions. This position works closely with the audits and QI team and other back office staff to ensure billing submissions are completed timely and accurately in order to keep the unbilled percentage below 10% of total revenue.

 

Responsibilities:

  • Perform end of episode claim audits for Medicare patient, per current protocol.
  • Perform quality face-to-face (F2F) reviews for new admissions.
  • Perform quality assurance (QA) audits as directed.
  • Follow up on open billing issues, as identified, within two working days.
  • Update incorrect OASIS for key field corrections discovered during billing audit.
  • Complete daily follow up for previous billing periods of incoming and received items that clear the claim to be billed and notify the home office billing department.
  • Utilize only the necessary data analytics reports in tableau to complete audit tasks timely and efficiently; front end audit and review claims demonstration tracker.
  • Enter clear and precise held claim notes so the branch can complete corrections within seven days.
  • Assist branch employees with follow up on all outstanding claims greater than 90 days.
  • Manage billing responsibilities in order to keep unbilled at 10% or less of total branch revenue.

Qualifications

Education and Experience (ESSENTIAL):

  • Must have a high school diploma or equivalent.

Education and Experience (DESIRED):

  • Two years experience with Medicare or related billing functions is preferred.

Qualifications:

  • Must be able to communicate effectively, both orally and in writing.
  • Must be well organized and able to manage time efficiently.
  • Must work well with minimal supervision and have strong work ethic.

Requirements:

  • Must possess a valid state driver license
    Must maintain automobile liability insurance as required by law