Remote Hcc Risk Adjustment Coder Jobs in Wisconsin

Job Location: Hybrid (United States)

Employment Type: Full-Time

About Summit Home Health & Hospice

Summit Home Health & Hospice is a Texas-based healthcare organization dedicated to enhancing the lives of patients and families through compassionate home health and hospice services. Our team is committed to delivering exceptional patient-centered care while maintaining the highest standards of clinical and operational excellence.

Summit Home Health & Hospice is seeking a detail-oriented and experienced Medical Billing Specialist to join our growing team. The Medical Billing Specialist will be responsible for processing medical claims, managing insurance reimbursements, resolving billing issues, and ensuring accurate and timely revenue cycle operations. The ideal candidate possesses strong knowledge of healthcare billing regulations, insurance verification procedures, and reimbursement processes within a home health or hospice environment.

Responsibilities

Prepare, review, and submit electronic and paper claims to Medicare, Medicaid, commercial insurance providers, and other payers.

Verify patient insurance eligibility, benefits, and coverage information.

Monitor claim status and follow up on unpaid, denied, or underpaid claims.

Investigate and resolve billing discrepancies and claim rejections.

Post payments, adjustments, and patient balances accurately within billing systems.

Communicate with insurance companies regarding claim submissions, appeals, and reimbursement issues.

Prepare and submit appeals for denied claims when appropriate.

Maintain accurate patient billing records and documentation.

Collaborate with clinical, intake, and administrative teams to ensure billing accuracy.

Generate billing reports and assist with revenue cycle analysis.

Ensure compliance with HIPAA, Medicare, Medicaid, and other applicable healthcare regulations.

Support month-end billing reconciliation and reporting activities.

Assist patients and families with billing inquiries in a professional and compassionate manner.

Requirements

High school diploma or equivalent.

Minimum of 2 years of medical billing experience.

Knowledge of Medicare, Medicaid, and commercial insurance billing processes.

Familiarity with CPT, ICD-10, and HCPCS coding standards.

Experience using Electronic Health Records (EHR) and medical billing software.

Strong attention to detail and organizational skills.

Excellent written and verbal communication skills.

Ability to work independently in a remote environment.

Compensation

Salary Range: $58,000 - $74,000 annually, depending on experience, qualifications, location, and demonstrated expertise.

Additional compensation opportunities may include:

Performance-based bonuses

Merit-based salary increases

Professional development reimbursement

Benefits

Medical, Dental, and Vision Insurance

401(k) Retirement Plan with Company Match

Paid Time Off (PTO)

Paid Holidays

Life and AD&D Insurance

Short-Term and Long-Term Disability Coverage

Employee Assistance Program (EAP)

Continuing Education and Professional Development Support

Remote Work Flexibility

Career Growth and Advancement Opportunities

Wellness Programs

Work Environment

Fully remote position available for qualified U.S.-based candidates.

High school diploma or equivalent.

Minimum of 2 years of medical billing experience.

Knowledge of Medicare, Medicaid, and commercial insurance billing processes.

Familiarity with CPT, ICD-10, and HCPCS coding standards.

Experience using Electronic Health Records (EHR) and medical billing software.

Strong attention to detail and organizational skills.

Excellent written and verbal communication skills.

Ability to work independently in a remote environment.

Medical, Dental, and Vision Insurance.

401(k) Retirement Plan with Company Match.

Paid Time Off (PTO).

Paid Holidays.

Life and AD&D Insurance.

Short-Term and Long-Term Disability Coverage.

Employee Assistance Program (EAP).

Continuing Education and Professional Development Support.

Remote Work Flexibility.

Career Growth and Advancement Opportunities.

Wellness Programs.

Work Environment.

Fully remote position available for qualified U.S.-based candidates.