Billing Professional - Medicare

Are you looking to make a difference in patients’ lives with a company that values your expertise? Join us in our mission of delivering compassionate healthcare where it matters most –– at home.

Pinnacle Home Care, Florida’s largest independent Medicare-certified home health provider, has been delivering high-quality, patient-centered care for over two decades, and we’re looking for a Reimbursement Analyst to join our award-winning team.

Key Responsibilities 

• Daily collection activities for designated accounts, leading to the timely reimbursement of receivables using available resources including external/internal databases, payer portals/websites, and telephone.
• Daily review of EOPs/EOB/Ras/EOMBs for accuracy and patient responsibility.
• Take appropriate action to resolve denied/rejected invoices and preparation of payer corrections and/or appeals in accordance with payer plan requirements using electronic and paper processes.
• Ensures that all reconciled items and past due balances are resolved to completion through contact and follow-up with Payers/Patients.
• Calculate expected reimbursement percentages based on contracted rates and properly notate accounts.
• Utilize appropriate systems to actively contact Payers/Patients for account transactions.
• Responds to all inquiries with a resolution to concerns and/or discrepancies.
• Identify trends, opportunities, and report data to direct supervisor same day.
• Meet productivity goals assigned by the Billing/Reimbursement Manager.
• Communicates professionally with inter-company departments on resolution of potential disputed items.
• Participates in payer webinars and conference calls covering a wide range of topics that enables the Billing Team to effectively bill and collect accounts receivable.
• Assists in the training of all new A/R personnel when needed.
• Complies with HIPAA regulations on all accounts.
• Protects the confidentiality of patient and organization information through effective controls and direct supervision of operations.
• Additional Duties/Tasks may apply as the business needs of the company evolve.

Qualifications

• High school diploma or equivalent; minimum of 2 years’ experience in revenue cycle collections.

• Strong knowledge of managed care, commercial insurance, and insurance portals.

• Proficient in interpreting insurance remittances and episodic billing methodologies (e.g., PPS, PDGM).

• Proficient in Microsoft Office and general computer applications.

• Ability to prepare and analyze reports and business correspondence.

• Excellent organizational and time management skills with the ability to meet tight deadlines.

Why Choose Pinnacle?

• Growth & Stability: Over two decades as Florida’s largest independent home health agency.
• Competitive Benefits & Perks: Including an employee referral program where you can earn rewards.
• Recognized Excellence: Ranked as a USA Today Top Workplace.
• Supportive & Fun Culture: Join a collaborative, forward-thinking team that values both professional excellence and personal fulfillment.

Pinnacle promotes an inclusive environment and is an equal opportunity employer. We prohibit discrimination or harassment based on race, religion, age, gender, national origin, disability, veteran status, or other legally protected characteristics.

Be part of a company that empowers clinicians to make a difference in the lives of over 10,000 patients across Florida every day. Apply now!