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ICON plcManage sponsor-dedicated clinical project delivery at ICON, a global clinical research services organization. Lead teams and oversee budgets, timelines, risks, and stakeholder reporting.
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Homecare Billing Specialist (Hybrid - Minnesota)
Manage homecare claims, authorizations, eligibility checks, denials, and reimbursement compliance for Minnesota DHS, Medicaid, and other payers.
विवरण
- Prepare and submit accurate electronic claims to DHS, Medicare and Medicaid managed care organizations, and commercial insurance payers, then track their status
- Verify that homecare claims contain the correct service codes, units, modifiers, and authorization details
- Confirm client eligibility, plan type, and benefit coverage through MN-ITS, payer portals, state systems, and other eligibility tools
- Handle claim resubmissions, voids, and billing adjustments
- Review authorization information and submit initial, concurrent, and renewal requests
- Monitor authorization progress, record expiration dates, and follow up on approvals and payer inquiries
- Investigate and resolve missing, inaccurate, denied, unpaid, or rejected claims and authorizations
- Work with payer representatives to address complex billing matters
- Record follow-up actions and escalate payment obstacles when needed
- Follow DHS, HIPAA, and payer-specific compliance requirements
- Support internal audits and payer audit requests
- Coordinate with Operations, Intake, Scheduling, and Case Management
- Share billing requirements, updates, and issues with internal staff
- Provide billing-related customer service to caregivers, clients, and external partners
- Keep authorization requests, approvals, denials, and renewals accurately documented
- Monitor reimbursement patterns and alert leadership to recurring payment problems
- Support month-end billing reconciliation
- Complete other assigned duties
आवश्यकताएँ
- High school diploma or equivalent is required
- An associate degree in Human Services or a similar field is preferred
- One to three years of experience in healthcare authorization, medical office administration, billing, case management, or payer coordination
- Experience with state authorization systems, payer portals, or managed care platforms
- Strong attention to detail and accurate documentation skills
- Excellent follow-through with the ability to manage multiple tasks and deadlines
- Strong communication skills and professional phone and email etiquette
- Ability to work independently while collaborating with multidisciplinary teams
- Experience with Medicaid, managed care plans, waivers, or state-funded programs
- Familiarity with clinical documentation, service codes, and prior authorization regulations
- Knowledge of HIPAA, healthcare privacy requirements, and payer authorization rules is preferred
- Experience working in a high-volume or fast-paced authorization environment
- Must pass a background study with the Minnesota Department of Human Services
- Must follow company remote work policies when working remotely
लाभ
- Full-time employment
- Hybrid remote work arrangement
- Remote work policies for employees working remotely
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