LifeCare Home Health Family

• Support day-to-day PECOS filings, vendor regulatory documentation, and provider credentialing activities. • Prepare and submit PECOS enrollments, revalidations, and updates under supervision. • Collect, organize, and maintain required ownership, managing employee, and practice location documentation. • Track CMS and MAC correspondence and assist with responses. • Collect and maintain required regulatory documentation for vendors and contractors. • Track expirables and ensure timely updates of required certifications and attestations. • Assist with regulatory onboarding and offboarding documentation. • Support credentialing activities, including license verification, certification tracking, and documentation management. • Maintain credentialing files and ensure alignment with enrollment and payer requirements. • Monitor expirables and notify leadership of upcoming renewals. • Maintain regulatory trackers, calendars, and filing logs. • Ensure records are organized, complete, and audit-ready. • Assist with internal audits and data validation reviews. • Coordinate with HR, Compliance, Operations, and Revenue Cycle to gather required information.

• Responsible for timely and compliant Private Duty billing, authorizations, and reimbursement for designated region • Work directly with revenue cycle director, billing compliance coordinator, agencies, and intermediary to facilitate billing claims • Obtain authorizations as needed • Prepare, audit, and submit claims electronically for appropriate payment • Follow up on outstanding claims and take appropriate action for timely payment • Collect necessary information to prepare claims, coordinating with agencies when appropriate • Bill and submit clean claims electronically and follow up with the Payer • Process, collect, and manage account payments • Monitor claims daily, report totals • Research, correct, and re-submit rejected and denied claims • Follow-up on corrections and report adjustments using revenue cycle management tool • Monitor and maintain assigned accounts • Review billing reports to maintain accurate AR balances • Document follow-ups on claim outstanding balance until final resolution is reached • Keep accurate and orderly records for all billing and accounts receivable activity • Conduct pre-billing audits as assigned • Proactive in identifying potential reimbursement issues while ensuring effective problem resolution • Coordinate with the Agency and Billing Compliance Coordinator on relevant process issues impacting billing • Report any billing issues that develop into trends to immediate supervisor • Answer questions from patients, agency staff, and insurance companies • Interpret and process Explanation of Benefits when needed • Professionally make outbound calls while improving customer relations • Maintain knowledge of current industry standards related to billing and cognizant of new regulations

• Assist in maintaining high quality of patient care in accordance with the Agency’s objectives and policies • Plan, coordinate, implement, and evaluate home health services • Educate and collaborate with field clinicians, clinical managers, and administrators on best practices • Review and monitor all Wellsky reports related to QA daily workflow to ensure timely processing of MD orders • Collaborate with key leadership to ensure STAR ratings, HHCAPS and VBP exceeds state/national levels • Assist with care coordination within branch locations to ensure appropriate visit utilization and quality care • Assist with end of episode billing • Identify training needs in branch locations and provide education as needed • Review and investigate clinical content, diagnoses, medical history, medications, and other procedures from the records of clients • Direct staff toward the appropriate use of community resources • Participate in the orientation of new professional staff

• Lead regional growth across Texas markets, guiding the continued expansion of Home Health and Hospice services. • Partner with operational and clinical leadership to shape regional strategy. • Build and develop high-performing sales teams. • Strengthen referral partnerships to fuel long-term success. • Drive sustainable census growth while ensuring patients and families gain access to compassionate care at home when it matters most.

• Maintain the quality of client care in accordance with the Agency’s objectives and policies • Direct and manage the field staff of the Agency while coordinating care with the interdisciplinary team, patient/family and referring Agency • Provide daily supervision of field nurses and Home Health Aides • Review and investigate the clinical content, diagnoses, medical history, medications, fee status and other procedures from the records of clients • Appraise staff performance during their probationary period and annually • Identify and evaluate client needs and appropriateness of home care

• Responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. • Ensures that Lifecare Home Health Family complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. • Lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen internal controls. • Responds timely and accurately to governmental audits for hospice and homecare. • Prepares and tracks appeals processes. • Assist with the development and implementation of a comprehensive compliance audit program tailored to meet the requirements of CMS, Medicaid, Medicare, Medicare Advantage plans, other government payors, private insurers, the Office of Inspector General (OIG) and the Department of Justice (DOJ). • Develop audit frameworks, methodologies and policies that align with regulatory requirements and best practices within healthcare. • Ensure audits are thoroughly documented and findings are reported with corrective action recommendations. • Assist with the establishment of a continuous monitoring system for compliance risks and policy effectiveness. • Conduct risk-based audits to assess the effectiveness of internal controls and adherence to internal policies. • Develop risk mitigation strategies and ensure corrective action plans are implemented. • Collaborate with departments such as Legal, Human Resources, Finance, IT, Quality, Billing and Coding to enhance internal controls and address and remediate compliance risks. • Provide guidance to operational teams on improving processes to ensure compliance with federal and state laws and regulations and internal policies. • Monitor emerging regulatory trends and enforcement actions to proactively address potential risks. • Draft and update audit related policies, procedures and guidelines. • Provide guidance on internal controls, regulatory requirements and audit best practices. • Develop and deliver compliance audit training and education to employees on regulatory requirements, compliance best practices and audit procedures. • Oversee internal investigations related to risk assessment and/or audit findings, conducting root cause analysis to identify trends or patterns of non-compliance. • Develop corrective action plans (CAPs) and track their implementation. • Ensure confidentiality and integrity in all investigations and reporting. • Serve as a trusted advisor to the Chief Compliance Officer, executive team and leadership. • Foster a culture of compliant and ethical behavior across the organization. • Collaborate with key stakeholders. • Support external auditors and regulatory agencies during compliance reviews and investigations.